Individual
DARIA TZU LIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13901 METROTECH DR, CHANTILLY, VA 20151-3234
(540) 428-1715
(540) 779-0028
Mailing address
7330 HERITAGE VILLAGE PLAZA, #102, GAINESVILLE, VA 20155
(540) 428-1715
(540) 779-0028
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009208
VA
363A00000X
Physician Assistant
PA09983
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
682934
MEDICARE PTAN
TX
01
—
687130
MEDICARE PTAN
TX
Enumeration date
09/24/2015
Last updated
05/19/2023
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