# ORIGIN IMAGING & DIAGNOSTICS LLC

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

## Provider details

- **NPI number:** 1194499103
- **Authorized official:** ALI MAZLOOM (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (832) 982-0845

## Contact information

- **Practice address:** 19610 TOMBALL PKWY STE 300, HOUSTON, TX 77070-3006
- **Practice address phone:** (832) 982-0845
- **Practice address fax:** (888) 663-9778
- **Mailing address:** 9135 KATY FWY, HOUSTON, TX 77024-1619
- **Mailing address phone:** (832) 982-0845
- **Mailing address fax:** (888) 663-9778

## Taxonomy

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

## Other

- **Enumeration date:** 08/03/2021
- **Last updated:** 11/23/2022