Pamela Adenuga

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D1091543 Issued in TX

Legal business name

PAMELA ADENUGA

Practice address

1901 Southeast Pkwy
Suite 106
Arlington, TX 76018-3605

Phone

(817) 704-8081

NPI assigned

Jan 8, 2010

Organization subpart

Yes

Parent organization

HIS GRACE MEDICAL SUPPLY AND MOREAs reported in NPPES

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

Authorized official

Name

Pamela Adenuga

Title

Director

Phone

(817) 704-8081

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• His Grace Lab Company Doing business as

Part of

His Grace Medical Supply and More

Locations

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1447580758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 SOUTHEAST PKWY",
            "address_2": "SUITE 106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760183605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SOUTHEAST PKWY",
            "address_2": "SUITE 106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760183605",
            "telephone_number": "817-704-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA ADENUGA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIS GRACE MEDICAL SUPPLY AND MORE",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "ADENUGA",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-704-8081"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D1091543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1091543",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "His Grace Lab Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Millicent Rose Palacios, DNP, APRN, CPNP
• Mariezernalyn Palmares
• Orinda M Palmer
• Sharon Louise Palmer, LMSW
• Thenessa Mack Palmer, LPC
• Philip Pan, D.D.S.
• Panaceb Enterprise LLC
• Paul Angelo Panaga, PMHNP-BC
• Niousha Panahi
• Saman Panahipour

• Clinical Medical Laboratory in Arlington, TX
• Providers in Arlington, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.