Provider Demographics
NPI:1801043567
Name:UNITED DIAGNOSTIC INC.
Entity Type:Organization
Organization Name:UNITED DIAGNOSTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:AVALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-995-4100
Mailing Address - Street 1:10500 FORUM PLACE DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8505
Mailing Address - Country:US
Mailing Address - Phone:713-995-4100
Mailing Address - Fax:713-995-4103
Practice Address - Street 1:10500 FORUM PLACE DR
Practice Address - Street 2:SUITE 126
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8505
Practice Address - Country:US
Practice Address - Phone:713-995-4100
Practice Address - Fax:713-995-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty