Healthcare Provider Details

I. General information

NPI: 1164502928
Provider Name (Legal Business Name): JULIE ANN STEWART PT, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 WELCH SCHOOL RD
COLLINSVILLE TX
76233-1433
US

IV. Provider business mailing address

1433 WELCH SCHOOL RD
COLLINSVILLE TX
76233-1433
US

V. Phone/Fax

Practice location:
  • Phone: 903-815-6922
  • Fax: 903-429-0493
Mailing address:
  • Phone: 903-815-6922
  • Fax: 903-429-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1150513
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: