| Mark D Eden Md Pa | |
|
820 Reuben St Ste B Fredericksburg TX 78624-4583 | |
| (830) 997-9497 | |
| (830) 997-5677 |
| Full Name | Mark D Eden Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 820 Reuben St Ste B, Fredericksburg, Texas |
| Authorized Official Name and Position | Mark D Eden (OWNER) |
| Authorized Official Contact | 8309979497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D Eden Md Pa 820 Reuben St Ste B Fredericksburg TX 78624-4583 Ph: (830) 997-9497 | Mark D Eden Md Pa 820 Reuben St Ste B Fredericksburg TX 78624-4583 Ph: (830) 997-9497 |
| NPI Number | 1114346814 |
|---|---|
| Provider Enumeration Date | 04/09/2014 |
| Last Update Date | 04/28/2014 |
| Medicare PECOS PAC ID | 2163645763 |
|---|---|
| Medicare Enrollment ID | O20140529001845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114346814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H6187 (Texas) | Primary |
| Provider Name | Mark D Eden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275528119 PECOS PAC ID: 8628033966 Enrollment ID: I20041129000095 |
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