Eden, Billy Max
Eden, Billy Max is an sole proprietor health care provider with primary practice located at 120 E Charnwood St Ste B, Tyler TX 75701-1708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sleep Medicine, which is considered as his primary health care specialty. Eden, Billy Max can be contacted via phone (903) 525-1664.Contact Information
Primary practice address
120 E Charnwood St Ste B
Tyler TX 75701-1708
Phone: (903) 525-1664
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | F8094 | Texas |
Profile Details
| NPI number | 1356370464 |
|---|---|
| LBN Legal business name | Eden, Billy Max |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 1st, 2006 |
| Last updated | Jan 5th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356370464 | NPPES |
| Texas | MEDICAID | 109389001 | |
| Texas | Other | 75-2616977-129 | |
| Texas | Other | 8FS313 | |
| Texas | Other | 75-2616977-026 | |
| Texas | MEDICAID | 131961809 | |
| Texas | Other | P01628359 |
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