# AIRLINE DIAGNOSIS CENTER LLC

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

## Provider details

- **NPI number:** 1093127516
- **Authorized official:** MR. GHOLAMHOSSEIN OMIDI (MEMBER MANAGER)
- **Authorized official phone:** (832) 878-2048

## Contact information

- **Practice address:** 5990 AIRLINE DR, 130A, HOUSTON, TX 77076-4233
- **Practice address phone:** (713) 884-8070
- **Practice address fax:** (713) 884-8077
- **Mailing address:** 5200 MITCHELLDALE ST, F-27, HOUSTON, TX 77092-7206
- **Mailing address phone:** (832) 878-2048
- **Mailing address fax:** (713) 956-2555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 06/02/2014