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General NPI Number Information
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NPI Number | 1669629424
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Entity Type | Organization
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Legal Business Name | DR-AL FAMILY AND URGENT CARE, PLC
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 14914 JEFFERSON DAVIS HWY
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City | WOODBRIDGE
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State | VA
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Zip | 22191-4016
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Country | US
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Telephone | 540-446-4706
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Fax | 540-658-1110
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Provider Business Mailing Address
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Address Line | 27 CRAWFORD LN
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City | STAFFORD
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State | VA
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Zip | 22556-6473
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Country | US
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Telephone | 540-446-4706
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF THE CORPORATION
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Name | DR. LIQAA SAID AL-KHOZAIE
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Credential | M.D.
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Telephone | 540-446-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0101236747
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License Number State | VA
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