Provider Demographics
NPI:1295755981
Name:STEWART, KAREN VANESSA (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:VANESSA
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 1:4650 WESTWAY PARK BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-2006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12952 BANDERA RD STE 105
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4690
Practice Address - Country:US
Practice Address - Phone:210-436-8400
Practice Address - Fax:833-452-1052
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12842207R00000X
TXS3882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89919-STOtherPROVIDER NUMBER
PR89919Medicare ID - Type UnspecifiedPROVIDER NUMBER
PR89919-STOtherPROVIDER NUMBER