MEDICARE: DR. KYLE DAVID STUART MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	A114085	CA
2	207X00000X	Orthopaedic Surgery Physician	N7005	TX
3	207X00000X	Orthopaedic Surgery Physician	DR.0071755	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3844669914	OTHER		MYUTMB 3844669914-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1215131800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE DAVID STUART MD

Provider Business Mailing Address
First Line	:	3310 LIVE OAK ST STE 575
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6153
Country	:	US
Telephone Number	:	214-824-7744
Fax Number	:	214-856-7991

Provider Business Practice Location Address
First Line	:	3310 LIVE OAK ST STE 575
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6153
Country	:	US
Telephone Number	:	214-824-7744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	03/04/2026

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