Provider Demographics
NPI:1992098719
Name:ABEBE, EYOEL T (MD)
Entity type:Individual
Prefix:DR
First Name:EYOEL
Middle Name:T
Last Name:ABEBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E STACY RD STE 306
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8738
Mailing Address - Country:US
Mailing Address - Phone:903-990-0001
Mailing Address - Fax:
Practice Address - Street 1:4645 AVON LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1301
Practice Address - Country:US
Practice Address - Phone:903-990-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5611207R00000X, 208M00000X
MI4301099441208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist