Organization
STEVEN L FIELDS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PITTMON (ADMINISTRATOR)
(903) 663-4800
Entity
Organization
Contact information
Practice address
2929 S HAMPTON RD, RENAISSANCE HOSPITAL - RADIOLOGY DEPARTMENT, DALLAS, TX 75224-3026
(214) 623-4400
Mailing address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-4800
(903) 663-0378
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J4109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188860402
—
TX
Enumeration date
05/24/2007
Last updated
03/09/2012
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