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General NPI Number Information
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NPI Number | 1275955650
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Entity Type | Organization
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Legal Business Name | AIRLINE MEDICAL CENTER AND DIAGNOSTICS,PLLC
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Dates
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Enumeration Date | 01/20/2014
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 1906 TREBLE DR STE 10
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City | HUMBLE
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State | TX
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Zip | 77338-5885
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Country | US
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Telephone | 713-691-7735
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Fax |
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Provider Business Mailing Address
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Address Line | 12547 SARATOGA WOODS LN
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City | HUMBLE
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State | TX
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Zip | 77346-3715
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Country | US
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Telephone | 832-527-2081
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MR. CHEDRIC L. COX SR.
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Credential |
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Telephone | 832-527-2081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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