MEDICARE: SHERYL A STEWART DENTAL PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1225439649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERYL A STEWART DENTAL PLLC

Provider Business Mailing Address
First Line	:	3300 S GESSNER RD STE 111
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-5139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1432
Country	:	US
Telephone Number	:	713-694-8556
Fax Number	:	713-782-1136

Authorized Official
Title or Position	:	OWNER
Name	:	RENEE GAVIOLA
Credential	:
Telephone Number	:	713-532-0997

Provider Enumeration Date	:	09/05/2014
Last Update Date	:	09/05/2014

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