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General NPI Number Information
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NPI Number | 1952300444
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Entity Type | Individual
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Provider Name | EBELE ELIZABETH OBIALO MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 4100 FAIRWAY DR STE 620
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City | CARROLLTON
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State | TX
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Zip | 75010-6539
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Country | US
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Telephone | 972-492-9901
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Fax | 972-492-9902
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Provider Business Mailing Address
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Address Line | PO BOX 378
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City | COPPELL
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State | TX
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Zip | 75019-0378
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Country | US
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Telephone | 972-492-9901
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Fax | 972-492-9902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | K8392
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K8392
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License Number State | TX
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