Organization
TRI-STATE SURGICAL ASSOCIATES
Active
Organization
TRI-STATE SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MEZA-VALENCIA C-SA (OWNER, PRESIDENT)
(571) 244-4684
Entity
Organization
Contact information
Practice address
10332 MAIN ST # 344, FAIRFAX, VA 22030-2410
(571) 244-4684
Mailing address
10332 MAIN ST # 344, FAIRFAX, VA 22030-2410
(571) 244-4684
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2011
Last updated
02/22/2014
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