MEDICARE: TEWODROS ABEBAW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1497601942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEWODROS ABEBAW

Provider Business Mailing Address
First Line	:	6434 S 82ND EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-2396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6434 S 82ND EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-2396
Country	:	US
Telephone Number	:	512-992-3784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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Directions to “ TEWODROS ABEBAW ” Practice Location

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