MEDICARE: DR. STEPHEN LEE STANFIELD O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3224TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	900919	OTHER	TX	BLOCK VISION
2	E65A	OTHER	TX	BLUE CROSS BLUE SHIELD
3	360340	OTHER	TX	CLARITY VISION
4	16121	OTHER	TX	SPECTERA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	TX3224	OTHER	TX	EYEMED

General Provider Information

NPI Number	:	1427099977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN LEE STANFIELD O.D.

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD STE 520
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3970
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	571-223-6780

Provider Business Practice Location Address
First Line	:	2406 HUNTER RD.
Second Line	:	STE. 102
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5256
Country	:	US
Telephone Number	:	512-754-6161
Fax Number	:	512-754-6197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/20/2020

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