Provider Demographics
NPI:1043298482
Name:HARDEE, ERIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:P
Last Name:HARDEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 BELLAIRE BLVD STE 575
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4535
Mailing Address - Country:US
Mailing Address - Phone:713-575-3686
Mailing Address - Fax:713-575-3688
Practice Address - Street 1:4747 BELLAIRE BLVD STE 575
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4535
Practice Address - Country:US
Practice Address - Phone:713-575-3686
Practice Address - Fax:713-575-3688
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL39862085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1509507-01Medicaid
TX84740RMedicare ID - Type UnspecifiedINDIVIDUAL M/C PROVIDER #
TXH59218Medicare UPIN