Active NPI
Adetokunboh Adegbenro, RPH
- Pharmacist
- Sealy, TX
National Provider Identifier
1659098093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39902
- Practice address
- 802 Meyer St
Sealy, TX 77474-3433 - Phone
- (979) 885-3538
- Fax
- (979) 885-3168
- NPI assigned
- Oct 26, 2022
- Last updated
- Oct 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 39902 | TX | Primary |
Addresses
Primary practice location
802 Meyer St
Sealy, TX 77474-3433
Mailing address
802 Meyer St
Sealy, TX 77474-3433
Phone (979) 885-3538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39902 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1659098093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 MEYER ST",
"city": "SEALY",
"state": "TX",
"postal_code": "774743433",
"telephone_number": "979-885-3538",
"fax_number": "979-885-3168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 MEYER ST",
"city": "SEALY",
"state": "TX",
"postal_code": "774743433",
"telephone_number": "979-885-3538",
"fax_number": "979-885-3168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEGBENRO",
"first_name": "ADETOKUNBOH",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "39902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sealy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.