Provider Demographics
NPI:1326211988
Name:STEPHEN L. STANFIELD
Entity Type:Organization
Organization Name:STEPHEN L. STANFIELD
Other - Org Name:TEXAS STATE OPTICAL OF SAN MARCOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-754-6161
Mailing Address - Street 1:2406 HUNTER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5255
Mailing Address - Country:US
Mailing Address - Phone:512-754-6161
Mailing Address - Fax:512-754-6197
Practice Address - Street 1:2406 HUNTER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5255
Practice Address - Country:US
Practice Address - Phone:512-754-6161
Practice Address - Fax:512-754-6197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3224TG305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1216244-01Medicaid
TX900919OtherBLOCKVISION
TX00E65AOtherBLUE CROSS BLUE SHIELD
TX1216244-01Medicaid