Divine Grace Family Clinic Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

DIVINE GRACE FAMILY CLINIC INC

Practice address

2455 Robinson Rd Ste 100
Grand Prairie, TX 75051-3852

Phone

(469) 660-0032

NPI assigned

Aug 14, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adeyinka Odafeme Oyekunle

Title

Owner

Phone

(502) 386-0112

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ethel O Bubu, PHARM.D.,RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Grand Prairie, TX
  • NPI 1568723708
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1386255065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 ROBINSON RD STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513852",
            "telephone_number": "469-660-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 ROBINSON RD STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513852",
            "telephone_number": "469-660-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GRACE FAMILY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-14",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "OYEKUNLE",
        "authorized_official_first_name": "ADEYINKA",
        "authorized_official_middle_name": "ODAFEME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-386-0112"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nguyen Dinh, PHARMD
• Marie Directo, PT
• Distinct Home Health Service LLC
• Divine Assurance Healthcare Services Inc.
• Divine Cure Health, Inc
• Divine Grace Home Care Inc
• Divine Help Incorporated
• Divine Lifting Home Care LLC
• Dloh Consulting, LLC
• DME Supply Company LLC

• Health Service Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Health Service Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.