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Organization
NORTH EAST REHAB CENTER WILLOWBROOK
Active
Organization
NORTH EAST REHAB CENTER WILLOWBROOK
Active
Other names
Thomas Mathew
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA ANN SHIRAH ADMINISTRATOR (CREDENTIALING SUPERVISOR)
(281) 646-1935
Entity
Organization
Contact information
Practice address
13300 HARGRAVE RD, SUITE 490, HOUSTON, TX 77070-4373
(281) 646-1935
(281) 646-0927
Mailing address
13300 HARGRAVE RD, SUITE 490, HOUSTON, TX 77070-4373
(281) 646-1935
(281) 646-0927
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1081537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1081537
PHYSICAL THERAPY LICENSE
TX
01
—
650546
BCBS ID
TX
Enumeration date
04/16/2007
Last updated
04/20/2008
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