Provider Demographics
NPI:1689755696
Name:TEPEYAC FAMILY CENTER, LLC
Entity Type:Organization
Organization Name:TEPEYAC FAMILY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-293-9440
Mailing Address - Street 1:4001 FAIR RIDGE DR STE 304
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2917
Mailing Address - Country:US
Mailing Address - Phone:703-273-9440
Mailing Address - Fax:703-273-9445
Practice Address - Street 1:4001 FAIR RIDGE DR STE 304
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2917
Practice Address - Country:US
Practice Address - Phone:703-273-9440
Practice Address - Fax:703-273-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty