Basic Information
Provider Information
NPI: 1164431607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEWART
FirstName: RONALD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7703 FLOYD CURL DR
Address2: DEPT OF SURGERY
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Practice Location
Address1: 7703 FLOYD CURL DR
Address2: DEPT OF SURGERY
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 06/04/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0102XH1414TXY Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care

ID Information
IDTypeStateIssuerDescription
11779740105TX MEDICAID
11779740201TXCIDCOTHER


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