Jose S Tissera MD LTD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101023093 Issued in VA

Legal business name

JOSE S TISSERA MD LTD

Practice address

8301 Arlington Blvd
#305
Fairfax, VA 22031-2902

Phone

(703) 573-2301

Fax

(703) 573-5104

NPI assigned

Sep 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Glenda Darlene McMaster

Title

Office Manager

Phone

(703) 573-2301

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1881888667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 ARLINGTON BLVD",
            "address_2": "#305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312902",
            "telephone_number": "703-573-2301",
            "fax_number": "703-573-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 ARLINGTON BLVD",
            "address_2": "#305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312902",
            "telephone_number": "703-573-2301",
            "fax_number": "703-573-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE S TISSERA MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "MCMASTER",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-573-2301",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101023093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6201156",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hoonchul Joo, D.C.
• Jessica Joo, MA, LMHC, LPC
• Lacy Jean Jordan White, LCSW
• Alysia Jordan, DPT
• Karida C Jordan, ATC, LMT
• Sheena Kiran Joseph-Bali, LPTA
• Allen E Joseph, MD
• Gouss Joseph, LPC
• Jacob T Joseph, M.D.
• Sharon R Josephson Keeven, CRNP

• Obstetrics & Gynecology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.