Individual ProviderEric PedenThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansPractice Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717(713) 441-5200PECOS EnrollmentBased on the most recent information from CMS, provider Eric Peden is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1356421770Provider TypeIndividualFull NamePeden, EricCredentialMDGenderMaleSole ProprietorNoEnumeration Date10/17/2006Last Updated11/2/2016Contact InformationPractice LocationPractice Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717Phone(713) 441-5200Fax(713) 793-7428Mailing LocationMailing Address6550 Fannin St, Suite 1401, Houston, TX 77030-2717Phone(713) 441-5200Fax(713) 793-7428Provider TaxonomiesCodeDescriptionLicenseCode208G00000XPrimaryDescriptionThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic PhysiciansLicenseJ8709TexasProvider IdentifiersIDDescriptionIssuerID038786206DescriptionMedicaidIssuerUnlistedTexasIDP01039339DescriptionOtherIssuerRR MEDICARETexasID038786201DescriptionMedicaidIssuerUnlistedTexasID8W8519DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasIDP00434000DescriptionOtherIssuerRR MEDICARETexasID038786207DescriptionMedicaidIssuerUnlistedTexas