Provider Demographics
NPI:1427099977
Name:STANFIELD, STEPHEN LEE (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEE
Last Name:STANFIELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:2406 HUNTER RD.
Practice Address - Street 2:STE. 102
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5256
Practice Address - Country:US
Practice Address - Phone:512-754-6161
Practice Address - Fax:512-754-6197
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3224TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX900919OtherBLOCK VISION
TXE65AOtherBLUE CROSS BLUE SHIELD
TX360340OtherCLARITY VISION
TX16121OtherSPECTERA
TX1216244-01Medicaid
TXTX3224OtherEYEMED
TXE65AOtherBLUE CROSS BLUE SHIELD
TX1216244-01Medicaid