Doctor Name: | PAMELA OLABISI ADENUGA |
NPI Number: | 1639370356 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 32015808465 |
Business Practice Address: | 1901 Southeast Pkwy Suite 107 Arlington, TX - 760183605 |
Business Phone Number: | 8175571668 |
Business Fax Number: | 8884416930 |
Mailing Address: | 1901 Southeast Pkwy, Suite 107 ARLINGTON |
State: | TX |
Postal Code: | 760183605 |
Phone Number: | 8175571668 |
Fax Number: | 8884416930 |
NPI Enumeration Date: | 05/30/2007 |
NPI Last Update Date: | 08/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 32015808465 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |