Provider Demographics
NPI:1841346525
Name:STUART, RODNEY WADE (MD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:WADE
Last Name:STUART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 RIVERSIDE DR STE 119
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3515
Mailing Address - Country:US
Mailing Address - Phone:694-232-9920
Mailing Address - Fax:469-232-9927
Practice Address - Street 1:6221 RIVERSIDE DR STE 119
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3515
Practice Address - Country:US
Practice Address - Phone:866-987-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0457207ZP0102X
UT6940834-1205207ZP0102X
FLNA207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN4136OtherTX MEDICAL BOARD
UT6940834-1205OtherUT MEDICAL BOARD
NY284816OtherNY MEDICAL BOARD
CAA109572OtherCA MEDICAL BOARD
AZ44710OtherAZ MEDICAL BOARD
LAMD.203418OtherLA MEDICAL BOARD
NMMD2009-0457OtherNM MEDICAL BOARD
CODR.0049560OtherCO MEDICAL BOARD