Provider Demographics
NPI:1912727454
Name:JALLOH-ADENEGAN, TENNEH (DC)
Entity type:Individual
Prefix:
First Name:TENNEH
Middle Name:
Last Name:JALLOH-ADENEGAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 FM 762 RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6436
Mailing Address - Country:US
Mailing Address - Phone:281-771-0659
Mailing Address - Fax:
Practice Address - Street 1:10415 W GRAND PKWY S UNIT 120
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8718
Practice Address - Country:US
Practice Address - Phone:281-816-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor