Provider Demographics
NPI:1417617465
Name:TU FAMILY MEDICAL AND VISION CLINIC LLC
Entity Type:Organization
Organization Name:TU FAMILY MEDICAL AND VISION CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALBUENA MONTSERRAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-212-7087
Mailing Address - Street 1:2946 SLEEPY HOLLOW RD STE B
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2003
Mailing Address - Country:US
Mailing Address - Phone:703-417-9678
Mailing Address - Fax:866-848-8971
Practice Address - Street 1:2946 SLEEPY HOLLOW RD STE B
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2003
Practice Address - Country:US
Practice Address - Phone:703-417-9678
Practice Address - Fax:866-848-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care