Provider Demographics
NPI:1588976732
Name:STEWART, RYAN A (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:A
Last Name:STEWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2929 CARLISLE ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1084
Mailing Address - Country:US
Mailing Address - Phone:214-965-9355
Mailing Address - Fax:214-922-0206
Practice Address - Street 1:2929 CARLISLE ST
Practice Address - Street 2:SUITE 350
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1084
Practice Address - Country:US
Practice Address - Phone:214-965-9355
Practice Address - Fax:214-922-0206
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor