Individual
MR. EDDIE MICHAEL HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
101 E JACKSON ST, BURNET, TX 78611-3101
(512) 756-7510
Mailing address
101 E JACKSON ST, BURNET, TX 78611-3101
(512) 756-7510
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
NM2008-0046
NM
363AM0700X
Medical Physician Assistant
Primary
PA03311
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57551251
—
NM
Enumeration date
10/27/2006
Last updated
07/08/2012
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