Provider Demographics
NPI:1578684056
Name:BIELFIELD, JONATHAN A (DO)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:A
Last Name:BIELFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JONATHAN
Other - Middle Name:ADAM
Other - Last Name:BIELFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1500 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1433
Mailing Address - Country:US
Mailing Address - Phone:512-485-7700
Mailing Address - Fax:512-485-7702
Practice Address - Street 1:1500 W 34TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1433
Practice Address - Country:US
Practice Address - Phone:512-485-7700
Practice Address - Fax:512-485-7702
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8528207N00000X
CODR0051149207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology