Provider Demographics
NPI:1235109083
Name:BERSHAD, ERIC M (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:BERSHAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 BAYLOR PLZ # NB-302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-8472
Mailing Address - Fax:713-798-3091
Practice Address - Street 1:1 BAYLOR PLZ # NB-302
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:713-798-8472
Practice Address - Fax:713-798-3091
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC834252084V0102X
NC2020-002112084V0102X
KY536492084V0102X
TXM9160207RC0200X, 2084A2900X, 2084N0400X, 2084V0102X
VA01012687542084V0102X
IN01083259A2084N0400X
AZ596162084V0102X
GA850852084V0102X
FLME1441732084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000374357OtherANTHEM
OH000000374357OtherANTHEM
TX8L0329Medicare PIN
TX8K8074Medicare PIN