MEDICARE: JAHANN STEWART

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	171W00000X	Contractor		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417307729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAHANN STEWART

Provider Business Mailing Address
First Line	:	2417 ACORN BND
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-3851
Country	:	US
Telephone Number	:	940-273-0163
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 ACORN BND
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-3851
Country	:	US
Telephone Number	:	940-273-0163
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	06/16/2016

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Directions to “ JAHANN STEWART ” Practice Location

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