Provider Demographics
NPI:1548740889
Name:ZEBAZE, TED (PMHNP-BC , APRN, MSN)
Entity type:Individual
Prefix:
First Name:TED
Middle Name:
Last Name:ZEBAZE
Suffix:
Gender:
Credentials:PMHNP-BC , APRN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7200 FOSSIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4759
Mailing Address - Country:US
Mailing Address - Phone:682-203-3318
Mailing Address - Fax:
Practice Address - Street 1:600 W 6TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3684
Practice Address - Country:US
Practice Address - Phone:817-406-2699
Practice Address - Fax:817-406-2699
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143276363LP0808X
TX951604163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse