Provider Demographics
NPI:1760526966
Name:LONGFIELD, ROBERT N (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:LONGFIELD
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:PO BOX 847824
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7824
Mailing Address - Country:US
Mailing Address - Phone:903-877-2827
Mailing Address - Fax:903-877-5661
Practice Address - Street 1:2303 SE MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3542
Practice Address - Country:US
Practice Address - Phone:903-877-2827
Practice Address - Fax:903-877-5661
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3488207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF14547Medicare UPIN
8492M1Medicare ID - Type Unspecified