Organization
DIVERSIFIED INDEPENDENT DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GRIGORIAN (DIRECTOR/OWNER)
(713) 650-9500
Entity
Organization
Contact information
Practice address
1701 WEBSTER ST STE C, HOUSTON, TX 77003-5800
(713) 650-9500
Mailing address
1701 WEBSTER ST STE C, HOUSTON, TX 77003-5800
(713) 650-9500
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
—
—
302F00000X
Exclusive Provider Organization
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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