Provider Demographics
NPI:1548282643
Name:E. HOUSTON REHAB.&MEDICAL SUPPLIES
Entity type:Organization
Organization Name:E. HOUSTON REHAB.&MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAMISHA
Authorized Official - Middle Name:DEJON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-673-9100
Mailing Address - Street 1:1717 E. LOOP NORTH FWY.
Mailing Address - Street 2:300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-4032
Mailing Address - Country:US
Mailing Address - Phone:713-673-9100
Mailing Address - Fax:713-673-9101
Practice Address - Street 1:1717 E. LOOP NORTH FWY.
Practice Address - Street 2:300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-4032
Practice Address - Country:US
Practice Address - Phone:713-673-9100
Practice Address - Fax:713-673-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089356332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies