Provider Demographics
NPI:1780012369
Name:W & A PEDIATRICS LLC
Entity Type:Organization
Organization Name:W & A PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOA
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-534-3331
Mailing Address - Street 1:6079 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2707
Mailing Address - Country:US
Mailing Address - Phone:703-534-3331
Mailing Address - Fax:703-534-0704
Practice Address - Street 1:6079 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2707
Practice Address - Country:US
Practice Address - Phone:703-534-3331
Practice Address - Fax:703-534-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235632208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty