MEDICARE: ANDREA OPAL EDEN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2010001130	MO
2	207Q00000X	Family Medicine Physician	6617	KS
3	207Q00000X	Family Medicine Physician	V8239	TX

General Provider Information

NPI Number	:	1245456821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA OPAL EDEN DO

Provider Business Mailing Address
First Line	:	1625 E 30TH AVE
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67502-1226
Country	:	US
Telephone Number	:	888-878-6881
Fax Number	:	620-728-0823

Provider Business Practice Location Address
First Line	:	3301 UNICORN LAKE BLVD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-0102
Country	:	US
Telephone Number	:	940-383-1578
Fax Number	:	940-382-0333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/15/2025

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Directions to “ ANDREA OPAL EDEN DO” Practice Location

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