Provider Demographics
NPI:1700828381
Name:HOPE REHAB LTD
Entity type:Organization
Organization Name:HOPE REHAB LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-252-3438
Mailing Address - Street 1:19538 INDIGO LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-3157
Mailing Address - Country:US
Mailing Address - Phone:281-252-3438
Mailing Address - Fax:832-476-6351
Practice Address - Street 1:850 FM 1960 RD W
Practice Address - Street 2:SUITE T
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3418
Practice Address - Country:US
Practice Address - Phone:832-249-6980
Practice Address - Fax:832-249-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001675261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
00346UMedicare ID - Type Unspecified