# ORIGIN DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003799404
- **Authorized official:** ALI MAZLOOM (CEO)
- **Authorized official phone:** (832) 429-2216

## Contact information

- **Practice address:** 17227 W GRAND PKWY S STE B, SUGAR LAND, TX 77479-3689
- **Practice address phone:** (281) 899-0019
- **Mailing address:** 9135 KATY FWY STE 102, HOUSTON, TX 77024-1636
- **Mailing address phone:** (832) 429-2216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2025
- **Last updated:** 08/08/2025