Organization Active NPI

Holly S. Stewart, MD PA

  • Primary Care Clinic/Center
  • Lubbock, TX
National Provider Identifier
1043358336
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
J8790 Issued in TX
Legal business name
HOLLY S. STEWART, MD PA
Practice address
3502 9TH St
Suite 360
Lubbock, TX 79415-3300
Phone
(806) 744-7764
Fax
(806) 744-7761
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Holly S Stewart, M.D.
Title
Owner Operator
Phone
(806) 744-7764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X J8790 TX Primary

Addresses

Primary practice location

3502 9TH St
Suite 360
Lubbock, TX 79415-3300

Mailing address

3502 9TH St
Suite 360
Lubbock, TX 79415-3300
Phone (806) 744-7764

Other identifiers 1

IdentifierTypeStateIssuer
J8790OtherTXSTATE MEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

3502 9th St
Ste 360
Lubbock, TX 79415
Phone (806) 414-2783

12002 Trafalgar Ave
Ste 201
Lubbock, TX 79424
Phone (806) 743-7761

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1043358336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 9TH ST",
            "address_2": "SUITE 360",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153300",
            "telephone_number": "806-744-7764",
            "fax_number": "806-744-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 9TH ST",
            "address_2": "SUITE 360",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153300",
            "telephone_number": "806-744-7764",
            "fax_number": "806-744-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY S. STEWART, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "806-744-7764",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "J8790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "J8790",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.