Provider Demographics
NPI:1326720343
Name:STEWART, SCOTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 KELLWAY CIR STE 108
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4254
Mailing Address - Country:US
Mailing Address - Phone:405-638-0345
Mailing Address - Fax:
Practice Address - Street 1:4275 KELLWAY CIR STE 108
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4254
Practice Address - Country:US
Practice Address - Phone:405-638-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX511241835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric