Provider Demographics
NPI:1700227758
Name:STEWART, JOHN (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 TOWNE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1201
Mailing Address - Country:US
Mailing Address - Phone:817-476-0027
Mailing Address - Fax:
Practice Address - Street 1:817 TOWNE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1201
Practice Address - Country:US
Practice Address - Phone:817-476-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00992171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist