Provider Demographics
NPI:1821810623
Name:ADEBUNMI, EMMANUEL ADETUNJI (RPH)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:ADETUNJI
Last Name:ADEBUNMI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9937 GARLAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3259
Mailing Address - Country:US
Mailing Address - Phone:214-328-4971
Mailing Address - Fax:214-328-4835
Practice Address - Street 1:9937 GARLAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3259
Practice Address - Country:US
Practice Address - Phone:214-328-4971
Practice Address - Fax:214-328-4835
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist