Provider Demographics
NPI:1275955650
Name:AIRLINE MEDICAL CENTER AND DIAGNOSTICS,PLLC
Entity Type:Organization
Organization Name:AIRLINE MEDICAL CENTER AND DIAGNOSTICS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHEDRIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:832-527-2081
Mailing Address - Street 1:12547 SARATOGA WOODS LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3715
Mailing Address - Country:US
Mailing Address - Phone:832-527-2081
Mailing Address - Fax:
Practice Address - Street 1:1906 TREBLE DR STE 10
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5885
Practice Address - Country:US
Practice Address - Phone:713-691-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251B00000XAgenciesCase Management