Provider Demographics
NPI:1063618007
Name:K.W. FIELDS INC.
Entity type:Organization
Organization Name:K.W. FIELDS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-353-3544
Mailing Address - Street 1:4700 FM 2920 RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3109
Mailing Address - Country:US
Mailing Address - Phone:281-353-3544
Mailing Address - Fax:281-288-5566
Practice Address - Street 1:4700 FM 2920 RD STE 1
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3109
Practice Address - Country:US
Practice Address - Phone:281-353-3544
Practice Address - Fax:281-288-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2435261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1891805024OtherTYPE 1 N.P.I. #
TX1891805024OtherTYPE 1 N.P.I. #
TX600838Medicare ID - Type Unspecified