Healthcare Provider Details

I. General information

NPI: 1770872822
Provider Name (Legal Business Name): RYAN GOODSON STEWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 S MAIN STREET SUITE 500
HOUSTON TX
77030
US

IV. Provider business mailing address

PO BOX 631607
CINCINNATI OH
45263-1607
US

V. Phone/Fax

Practice location:
  • Phone: 713-730-2229
  • Fax: 713-396-3854
Mailing address:
  • Phone: 713-730-2229
  • Fax: 281-681-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number2011-00405
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberP9744
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: