Provider Demographics
NPI:1528949179
Name:ADEGOKE, NURAIN A (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NURAIN
Middle Name:A
Last Name:ADEGOKE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 MAYFIELD VILLA DR APT 15208
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-4735
Mailing Address - Country:US
Mailing Address - Phone:682-234-5309
Mailing Address - Fax:
Practice Address - Street 1:5050 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7415
Practice Address - Country:US
Practice Address - Phone:214-375-8924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist