| The Stewpot | |
|
1822 Young St Dallas TX 75201-5612 | |
| (214) 590-0153 | |
| Not Available |
| Full Name | The Stewpot |
|---|---|
| Speciality | Clinic/Center |
| Location | 1822 Young St, Dallas, Texas |
| Authorized Official Name and Position | Frederick P. Cerise (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2145908006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Stewpot Po Box 660599 Dallas TX 75266-0599 | The Stewpot 1822 Young St Dallas TX 75201-5612 Ph: (214) 590-0153 |
| NPI Number | 1356852784 |
|---|---|
| Provider Enumeration Date | 10/12/2017 |
| Last Update Date | 06/17/2025 |
| Certification Date | 06/17/2025 |
| Medicare PECOS PAC ID | 8325934813 |
|---|---|
| Medicare Enrollment ID | O20130903000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356852784 | NPI | - | NPPES |
| 337076901 | Medicaid | TX | |
| 337076902 | Medicaid | TX |
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