Basic Information
| Provider Information | |||||||||
| NPI: | 1770556474 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTHSOUTH OF TEXAS INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HEALTHSOUTH REHABILITATION HOSPITAL OF HUMBLE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19002 MCKAY BLVD | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773385701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814466148 | ||||||||
| FaxNumber: | 2814468022 | ||||||||
| Practice Location | |||||||||
| Address1: | 19002 MCKAY BLVD | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773385701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814466148 | ||||||||
| FaxNumber: | 2814468022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2006 | ||||||||
| LastUpdateDate: | 04/10/2014 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SAYWARD | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | IP BUSINESS OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9547136165 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | Y | Hospitals | Rehabilitation Hospital |
ID Information
| ID | Type | State | Issuer | Description | HH05826 | 01 | BLUE CROSS | OTHER | 094342502 | 05 | TX | MEDICAID |