MEDICARE: TED ZEBAZE PMHNP-BC , APRN, MSN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1143276	TX

General Provider Information

NPI Number	:	1548740889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TED ZEBAZE PMHNP-BC , APRN, MSN

Provider Business Mailing Address
First Line	:	7200 FOSSIL CREEK DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4759
Country	:	US
Telephone Number	:	682-203-3318
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W 6TH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3684
Country	:	US
Telephone Number	:	817-406-2699
Fax Number	:	817-406-2699

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

Provider Enumeration Date	:	08/16/2018
Last Update Date	:	03/28/2025

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