Individual
EBELE ELIZABETH OBIALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4100 FAIRWAY DR STE 620, CARROLLTON, TX 75010-6539
(972) 492-9901
(972) 492-9902
Mailing address
PO BOX 378, COPPELL, TX 75019-0378
(972) 492-9901
(972) 492-9902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K8392
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
K8392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144194123
—
TX
01
—
8M7340
BCBS
TX
Enumeration date
07/18/2005
Last updated
06/02/2022
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