Provider Demographics
NPI:1386723583
Name:TRAHOS MEDICAL ENTERPRISES PLLC
Entity type:Organization
Organization Name:TRAHOS MEDICAL ENTERPRISES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-998-4913
Mailing Address - Street 1:205 S WHITING ST STE 303
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3632
Mailing Address - Country:US
Mailing Address - Phone:703-998-4913
Mailing Address - Fax:703-931-8171
Practice Address - Street 1:205 S WHITING ST STE 303
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3632
Practice Address - Country:US
Practice Address - Phone:703-998-4913
Practice Address - Fax:703-931-8171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102035626207Q00000X, 207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2138371OtherUNITED HEALTHCARE/ONE NET PPO
VA010201021Medicaid
VA144441OtherSOUTHERN HEALTH SERV. INC.
VA470178OtherAETNA HMO
DC8857-0001OtherBC/BS OF NATIONAL CAPITAL AREA
VA182247OtherANTHEM BC/BS OF VA
VA280953OtherUNITED HEALTHCARE
VA976064OtherMAILHANDLERS
VA1433740OtherCIGNA
VA8138371OtherMDIPA/OPTIMUM CHOICE HMO
VA4088139OtherAETNA
VA503495OtherUNICARE
G02178Medicare PIN
D84002Medicare UPIN
DD8984Medicare PIN