Healthcare Provider Details

I. General information

NPI: 1811423577
Provider Name (Legal Business Name): CATHERINE MILLER STEWART PT, DPT, NCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6913 CAMP BOWIE BLVD SUITE 141
FORT WORTH TX
76116-7163
US

IV. Provider business mailing address

2608 MUSEUM WAY NO. 3206
FORT WORTH TX
76107-3080
US

V. Phone/Fax

Practice location:
  • Phone: 682-312-7693
  • Fax:
Mailing address:
  • Phone: 704-619-0905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1209360
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: