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Individual

EDEN CHRISTIAN HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
6102 PRIVATE ROAD 6470, LUBBOCK, TX 79416-3351
(806) 789-4871

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0420017989
VT
208000000X
Pediatrics Physician
Primary
175086
FL
208000000X
Pediatrics Physician
CDR.0005149
CO
208000000X
Pediatrics Physician
TL8632
WY
208000000X
Pediatrics Physician
V6597
TX

Other

Enumeration date
04/23/2021
Last updated
09/29/2025
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