Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | M8010 | TX |
NPI | 1316159841 |
---|---|
Provider Name | Dr. Katie Grysen Stewart |
First Address | Dallas, TX 75219-3924 |
Second Address | Dallas, TX 75219-3924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 10/07/2008 |