Provider Demographics
NPI:1811130701
Name:TEBEBI, ELKANA ABAM
Entity type:Individual
Prefix:
First Name:ELKANA
Middle Name:ABAM
Last Name:TEBEBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8746 FONDREN VILLAGE DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071
Mailing Address - Country:US
Mailing Address - Phone:713-979-6893
Mailing Address - Fax:281-974-1498
Practice Address - Street 1:8746 FONDREN VILLAGE DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071
Practice Address - Country:US
Practice Address - Phone:713-979-6893
Practice Address - Fax:281-974-1498
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)