Provider Demographics
NPI:1538260641
Name:STEWART, GREGORY LOWELL (DAC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LOWELL
Last Name:STEWART
Suffix:
Gender:M
Credentials:DAC
Other - Prefix:MR
Other - First Name:GREGORY
Other - Middle Name:LOWELL
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ADDICTION THERAPIST
Mailing Address - Street 1:9131 AUTUMN MDWS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-1967
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:210-949-3306
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)