Provider Demographics
NPI:1174733166
Name:SUPERIOR DIAGNOSTICS INC
Entity type:Organization
Organization Name:SUPERIOR DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:K. CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-968-2300
Mailing Address - Street 1:2727 ALLEN PKWY STE 1915
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-2177
Mailing Address - Country:US
Mailing Address - Phone:281-968-2300
Mailing Address - Fax:
Practice Address - Street 1:10019 MAIN ST STE A9-B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5256
Practice Address - Country:US
Practice Address - Phone:281-968-2300
Practice Address - Fax:281-968-2301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPERIOR DIAGNOSTIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-22
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ02072084N0400X
291U00000X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical Laboratory