Provider Demographics
NPI:1669629424
Name:DR-AL FAMILY AND URGENT CARE, PLC
Entity Type:Organization
Organization Name:DR-AL FAMILY AND URGENT CARE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:LIQAA
Authorized Official - Middle Name:SAID
Authorized Official - Last Name:AL-KHOZAIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-446-4706
Mailing Address - Street 1:27 CRAWFORD LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-6473
Mailing Address - Country:US
Mailing Address - Phone:540-446-4706
Mailing Address - Fax:
Practice Address - Street 1:14914 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4016
Practice Address - Country:US
Practice Address - Phone:540-446-4706
Practice Address - Fax:540-658-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236747261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center