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Individual
ERIC PEDEN
Active
Individual
ERIC PEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
J8709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038786201
—
TX
05
—
038786206
—
TX
05
—
038786207
—
TX
01
—
8W8519
BLUE CROSS BLUE SHIELD
TX
01
—
P00434000
RR MEDICARE
TX
01
—
P01039339
RR MEDICARE
TX
Enumeration date
10/17/2006
Last updated
11/02/2016
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