Provider Demographics
NPI:1790995223
Name:JULIE STEWART
Entity Type:Organization
Organization Name:JULIE STEWART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-815-6922
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:
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X442Medicare PIN