Organization Active NPI

Airline Diagnosis Center LLC

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1093127516
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AIRLINE DIAGNOSIS CENTER LLC
Practice address
5990 Airline Dr
130A
Houston, TX 77076-4233
Phone
(713) 884-8070
Fax
(713) 884-8077
NPI assigned
Jun 2, 2014
Last updated
Jun 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Mr. Gholamhossein Omidi
Title
Member Manager
Phone
(832) 878-2048

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

5990 Airline Dr
130A
Houston, TX 77076-4233

Mailing address

5200 Mitchelldale St
F-27
Houston, TX 77092-7206
Phone (832) 878-2048

National Provider Directory

National Provider Directory

Locations

5200 Mitchelldale St
Ste F27
Houston, TX 77092
Phone (832) 878-2044

5990 Airline Dr
#130A
Houston, TX 77076
Phone (713) 884-8070

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1093127516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 MITCHELLDALE ST",
            "address_2": "F-27",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770927206",
            "telephone_number": "832-878-2048",
            "fax_number": "713-956-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5990 AIRLINE DR",
            "address_2": "130A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770764233",
            "telephone_number": "713-884-8070",
            "fax_number": "713-884-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIRLINE DIAGNOSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "OMIDI",
        "authorized_official_first_name": "GHOLAMHOSSEIN",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "832-878-2048",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.