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General NPI Number Information
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NPI Number | 1356370464
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Entity Type | Individual
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Provider Name | BILLY MAX EDEN MD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 120 E CHARNWOOD ST STE B
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City | TYLER
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State | TX
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Zip | 75701-1708
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Country | US
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Telephone | 903-525-1664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 846098
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City | DALLAS
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State | TX
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Zip | 75284-6098
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Country | US
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Telephone | 903-324-6400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | F8094
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License Number State | TX
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