| Organization Name: | TOM STEWARD, P.A. |
| NPI Number: | 1255605713 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS S. STEWARD (OWNER) |
| Mailing Address: | 1475 Central Ave Ste 220 Los Alamos |
| State: | NM US |
| Postal Code: | 875444207 |
| Phone Number: | 5054120010 |
| Fax Number: | |
| NPI Enumeration Date: | 03/01/2012 |
| NPI Last Update Date: | 03/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0102111 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |