Dr. Ebenezer Zentah Fozao, MD, DO.
Emergency Medicine in Tyler, TX. Individual provider (NPI-1).
NPI number1861999021
StatusActive
Last updated in NPPESAug 25, 2022
Details
- NPI
- 1861999021
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ebenezer Zentah Fozao
- Credential
- MD, DO.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2018
- Certification date
- Aug 25, 2022
- Last updated
- Aug 25, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | T6568 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
800 E Dawson StTyler, TX 75701-2036
Phone 903-606-4262
Mailing address
Po Box 841656Dallas, TX 75284-1656
Phone 903-531-5000
Other practice locations
2201 Hempstead Tpke
East Meadow, NY 11554-1859
East Meadow, NY 11554-1859
Phone 516-296-2899 · Fax 516-572-5465
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