NPIMap

Organization Active NPI

Origin Diagnostics LLC

  • Radiology Clinic/Center
  • Sugar Land, TX
National Provider Identifier
1003799404
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
ORIGIN DIAGNOSTICS LLC
Practice address
17227 W Grand Pkwy S Ste B
Sugar Land, TX 77479-3689
Phone
(281) 899-0019
NPI assigned
Jul 31, 2025
Last updated
Aug 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ali MazloomNPI 1962794560
Title
Ceo
Phone
(832) 429-2216

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

17227 W Grand Pkwy S Ste B
Sugar Land, TX 77479-3689

Mailing address

9135 Katy Fwy Ste 102
Houston, TX 77024-1636
Phone (832) 429-2216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, TX, LA, OK, CA6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20250912000687 CT Part B Supplier - Clinic/Group Practice 3173026499 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Avon, CT
O20250917003336 TX Part B Supplier - Clinic/Group Practice 3173026499 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX; The Woodlands, TX; Sugar Land, TX; Carrollton, TX
O20250918001288 LA Part B Supplier - Clinic/Group Practice 3173026499 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shreveport, LA; New Orleans, LA; Lafayette, LA
O20250918002656 OK Part B Supplier - Clinic/Group Practice 3173026499 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oklahoma City, OK
O20251002003499 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3173026499 Practice locations: Sugar Land, TX
O20251210001640 CA Part B Supplier - Clinic/Group Practice 3173026499 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fullerton, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Origin Diagnostics LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19610 Tomball Pkwy
Ste 300
Houston, TX 77070
Phone (832) 429-2216

17227 W Grand Pkwy S
#B
Sugar Land, TX 77479
Phone (281) 899-0019

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1003799404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9135 KATY FWY STE 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241636",
            "telephone_number": "832-429-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17227 W GRAND PKWY S STE B",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793689",
            "telephone_number": "281-899-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGIN DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "MAZLOOM",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-429-2216"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.