MEDICARE: DR. CECILIA D STEWART M.D.

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	2080N0001X	Neonatal-Perinatal Medicine Physician	L4736	TX
2	208000000X	Pediatrics Physician	L4736	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306812151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CECILIA D STEWART M.D.

Provider Business Mailing Address
First Line	:	PO BOX 975190
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75397-5190
Country	:	US
Telephone Number	:	281-412-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	14027 MEMORIAL DR STE 252
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-6826
Country	:	US
Telephone Number	:	281-412-2494
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	01/30/2017

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