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General NPI Number Information
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NPI Number | 1376708727
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Entity Type | Organization
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Legal Business Name | ADVANCED DIAGNOSTIC MEDICAL CLINIC,INC
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 6420 RICHMOND AVE STE 580
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City | HOUSTON
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State | TX
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Zip | 77057-5922
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Country | US
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Telephone | 323-828-4255
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Fax | 818-767-7228
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Provider Business Mailing Address
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Address Line | 6420 RICHMOND AVE STE 580
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City | HOUSTON
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State | TX
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Zip | 77057-5922
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Country | US
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Telephone | 323-828-4255
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Fax | 818-767-7228
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. ALBERT NAZARYAN
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Credential |
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Telephone | 323-828-4255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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