Healthcare Provider Details

I. General information

NPI: 1386614733
Provider Name (Legal Business Name): EDWARD J ZABAWSKI JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CRAWFORD AVE STE D
GRANBURY TX
76048-4562
US

IV. Provider business mailing address

1200 CRAWFORD AVE STE D
GRANBURY TX
76048-4562
US

V. Phone/Fax

Practice location:
  • Phone: 817-661-1520
  • Fax: 888-323-0020
Mailing address:
  • Phone: 817-661-1520
  • Fax: 888-323-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberK1959
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: