Provider Demographics
NPI:1023194883
Name:CONRAD, ERNEST U III (MD)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:U
Last Name:CONRAD
Suffix:III
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 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:206-940-1747
Mailing Address - Fax:
Practice Address - Street 1:5420 WEST LOOP S STE 2400
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2118
Practice Address - Country:US
Practice Address - Phone:713-486-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00024030207X00000X
TXR76932086X0206X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7330OtherINTERNAL ID-MOTOR VEHICLE ID
WA8105223Medicaid
106331Medicare ID - Type Unspecified
7330OtherINTERNAL ID-MOTOR VEHICLE ID