| Doctor Name: | MR. EDDIE MICHAEL HENDERSON |
| NPI Number: | 1801971676 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | NM2008-0046 |
| Business Practice Address: | 101 E Jackson St Burnet, TX - 786113101 |
| Business Phone Number: | 5127567510 |
| Business Fax Number: | |
| Mailing Address: | 101 E Jackson St, BURNET |
| State: | TX |
| Postal Code: | 786113101 |
| Phone Number: | 5127567510 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 07/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | NM2008-0046 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |