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General NPI Number Information
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NPI Number | 1043358336
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Entity Type | Organization
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Legal Business Name | HOLLY S. STEWART, MD PA
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 3502 9TH ST SUITE 360
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City | LUBBOCK
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State | TX
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Zip | 79415-3300
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Country | US
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Telephone | 806-744-7764
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Fax | 806-744-7761
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Provider Business Mailing Address
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Address Line | 3502 9TH ST SUITE 360
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City | LUBBOCK
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State | TX
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Zip | 79415-3300
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Country | US
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Telephone | 806-744-7764
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Fax | 806-744-7761
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | HOLLY S STEWART
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Credential | M.D.
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Telephone | 806-744-7764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | J8790
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License Number State | TX
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