Thomas Wesley Stidvent, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

E2879 Issued in TX

Practice address

3501 N 19TH St
Waco, TX 76708-2007

Phone

(254) 756-2171

Fax

(254) 745-5119

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649361965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8216 TEAKWOOD DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767122426",
            "telephone_number": "254-776-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N 19TH ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767082007",
            "telephone_number": "254-756-2171",
            "fax_number": "254-745-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIDVENT",
        "first_name": "THOMAS",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "E2879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1287674",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald A Stewart, MD
• Lisa Jane Stewart, LCDC
• Megan Stewart, PA(ASCP)
• Robert William Stewart, M.D.
• Tyler Stewart
• Vivian L Stidvent, LPC
• Stephen Stimson, MD
• Jennifer Renee' Stinson, FNP-C
• Samantha A Stockreef, RN
• Richard A. Stolze, PA-C

• Child & Adolescent Psychiatry Physician in Waco, TX
• Providers in Waco, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.