Provider Demographics
NPI:1568478444
Name:STEWART, SHERYL ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 TEXAS PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2183
Mailing Address - Country:US
Mailing Address - Phone:281-403-0083
Mailing Address - Fax:281-261-0039
Practice Address - Street 1:1761 TEXAS PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2183
Practice Address - Country:US
Practice Address - Phone:281-403-0083
Practice Address - Fax:281-261-0039
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174580401Medicaid