Provider Demographics
NPI:1376650648
Name:STEWART, EWA KATARZYNA (MD)
Entity Type:Individual
Prefix:DR
First Name:EWA
Middle Name:KATARZYNA
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9918 WATERVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-9523
Mailing Address - Country:US
Mailing Address - Phone:972-463-3227
Mailing Address - Fax:
Practice Address - Street 1:2376 LAVON DR STE 130
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9001
Practice Address - Country:US
Practice Address - Phone:972-496-6633
Practice Address - Fax:972-530-2420
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9430208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042120805Medicaid
TX042120805Medicaid