Provider Demographics
NPI:1699036020
Name:HARDISON, SCOTT ALLEN (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALLEN
Last Name:HARDISON
Suffix:
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5303
Mailing Address - Country:US
Mailing Address - Phone:409-772-2701
Mailing Address - Fax:409-772-1715
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-4220
Practice Address - Country:US
Practice Address - Phone:409-772-2701
Practice Address - Fax:409-772-1715
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48282207Y00000X
NC2017-00480207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology