Provider Demographics
NPI:1164502928
Name:STEWART, JULIE ANN (PT, MPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 WELCH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76233-1433
Mailing Address - Country:US
Mailing Address - Phone:903-815-6922
Mailing Address - Fax:903-429-0493
Practice Address - Street 1:1433 WELCH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:TX
Practice Address - Zip Code:76233-1433
Practice Address - Country:US
Practice Address - Phone:903-815-6922
Practice Address - Fax:903-429-0493
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X442Medicare PIN
TX8F4793Medicare PIN