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Organization
OUTREACH DIAGNOSTIC CLINIC
Active
Organization
OUTREACH DIAGNOSTIC CLINIC
Active
Other names
Wills Diagnostic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OMAR KIGGUNDU (CHIEF OPERATING OFFICER)
(713) 532-7311
Entity
Organization
Contact information
Practice address
2000 CRAWFORD ST, SUITE 900, HOUSTON, TX 77002-9011
(713) 651-0870
Mailing address
5120 WOODWAY DRIVE, SUITE 7012, HOUSTON, TX 77056-1791
(713) 532-7311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F0083
TX
207R00000X
Internal Medicine Physician
M3453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197746401
—
TX
Enumeration date
07/23/2008
Last updated
09/18/2013
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