MEDICARE: DOROTHY STUART

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	364SH0200X	Home Health Clinical Nurse Specialist	020884	TX

General Provider Information

NPI Number	:	1629712294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY STUART

Provider Business Mailing Address
First Line	:	826 FOREST HILLSIDE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-3021
Country	:	US
Telephone Number	:	317-489-2315
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 N SAM HOUSTON PKWY E STE 360B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-4029
Country	:	US
Telephone Number	:	832-295-3893
Fax Number	:

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

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	04/20/2022

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Directions to “ DOROTHY STUART ” Practice Location

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