Provider Demographics
NPI:1114917135
Name:BARFIELD, RUSSELL LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LEE
Last Name:BARFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 CALLE MILAGRO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7520
Mailing Address - Country:US
Mailing Address - Phone:808-351-1151
Mailing Address - Fax:
Practice Address - Street 1:1029 CALLE MILAGRO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7520
Practice Address - Country:US
Practice Address - Phone:808-351-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI124582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202029901Medicaid
TX202029901Medicaid