Provider Demographics
NPI:1306254016
Name:STEWART, ELIZABETH ANN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:1717 N IH 35
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2928
Mailing Address - Country:US
Mailing Address - Phone:512-964-6992
Mailing Address - Fax:512-610-5679
Practice Address - Street 1:1717 N IH 35
Practice Address - Street 2:SUITE 200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2928
Practice Address - Country:US
Practice Address - Phone:512-964-6992
Practice Address - Fax:512-610-5679
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant