Provider Demographics
NPI:1912075300
Name:STEWART, G. RENE'E (CPM)
Entity type:Individual
Prefix:
First Name:G.
Middle Name:RENE'E
Last Name:STEWART
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-3394
Mailing Address - Country:US
Mailing Address - Phone:972-530-3443
Mailing Address - Fax:972-496-6853
Practice Address - Street 1:6416 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-3394
Practice Address - Country:US
Practice Address - Phone:972-530-3443
Practice Address - Fax:972-496-6853
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96036176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife