MEDICARE: STEPHEN L. STANFIELD

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	305R00000X	Preferred Provider Organization	3224TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	900919	OTHER	TX	BLOCKVISION
3	00E65A	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1326211988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN L. STANFIELD

Provider Business Mailing Address
First Line	:	2406 HUNTER RD
Second Line	:	SUITE 102
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5255
Country	:	US
Telephone Number	:	512-754-6161
Fax Number	:	512-754-6197

Provider Business Practice Location Address
First Line	:	2406 HUNTER RD
Second Line	:	SUITE 102
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5255
Country	:	US
Telephone Number	:	512-754-6161
Fax Number	:	512-754-6197

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. STEPHEN LEE STANFIELD
Credential	:	O.D.
Telephone Number	:	512-754-6161

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	02/16/2012

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Directions to “STEPHEN L. STANFIELD ” Practice Location

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