Provider Demographics
NPI:1043795222
Name:HARDEMAN, GERALD E JR
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:E
Last Name:HARDEMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 17TH AVE N
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-5347
Mailing Address - Country:US
Mailing Address - Phone:281-705-0344
Mailing Address - Fax:
Practice Address - Street 1:2021 17TH AVE N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5347
Practice Address - Country:US
Practice Address - Phone:281-705-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)