Healthcare Provider Details

I. General information

NPI: 1629348909
Provider Name (Legal Business Name): TIOMARA PAYLOR DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2922 TELESTAR CT
FALLS CHURCH VA
22042-1206
US

IV. Provider business mailing address

2922 TELESTAR CT
FALLS CHURCH VA
22042-1206
US

V. Phone/Fax

Practice location:
  • Phone: 703-584-2040
  • Fax: 703-560-7218
Mailing address:
  • Phone: 703-584-2040
  • Fax: 703-560-7218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301056
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103301056
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: