Provider Demographics
NPI:1841039781
Name:STEWARD, RADONICA
Entity type:Individual
Prefix:
First Name:RADONICA
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 W NORTHWEST HWY STE 3106
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-4433
Mailing Address - Country:US
Mailing Address - Phone:214-497-2037
Mailing Address - Fax:
Practice Address - Street 1:2351 W NORTHWEST HWY STE 3106
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4433
Practice Address - Country:US
Practice Address - Phone:214-497-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX023052251E00000X, 374U00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide