Organization
ORIGIN DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI MAZLOOM (CEO)
(832) 429-2216
Entity
Organization
Contact information
Practice address
17227 W GRAND PKWY S STE B, SUGAR LAND, TX 77479-3689
(281) 899-0019
Mailing address
9135 KATY FWY STE 102, HOUSTON, TX 77024-1636
(832) 429-2216
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
07/31/2025
Last updated
08/08/2025
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