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NPI Code Detail

MEDICARE: JULIE A FIELDS MD

MEDICARE: JULIE A FIELDS MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianM5197TX

General Provider Information

NPI Number : 1154379907
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE A FIELDS MD
Provider Business Mailing Address
First Line : P.O. BOX 961205
Second Line :
City : FORT WORTH
State : TX
Zip : 76161-1205
Country : US
Telephone Number : 817-740-8400
Fax Number :
Provider Business Practice Location Address
First Line : 2909 LACKLAND RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-4119
Country : US
Telephone Number : 817-854-8440
Fax Number : 817-377-5074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 11/21/2019

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