Provider Demographics
NPI:1699784603
Name:FELD, STEVEN LEIGH (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:LEIGH
Last Name:FELD
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 1:710 GASLIGHT BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3153
Mailing Address - Country:US
Mailing Address - Phone:936-639-0988
Mailing Address - Fax:
Practice Address - Street 1:710 GASLIGHT BLVD
Practice Address - Street 2:STE A
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3153
Practice Address - Country:US
Practice Address - Phone:936-639-0988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9325207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060061292OtherRR MEDICARE
TX096914905Medicaid
TX096914901Medicaid
TX0071ETOtherBLUE CROSS
TXTXB148819Medicare PIN
G02736Medicare UPIN
TX096914905Medicaid