Provider Demographics
NPI:1598215535
Name:ONADEKO, ADEJUMOKE (NP)
Entity Type:Individual
Prefix:
First Name:ADEJUMOKE
Middle Name:
Last Name:ONADEKO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2263
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75047-2263
Mailing Address - Country:US
Mailing Address - Phone:469-835-7543
Mailing Address - Fax:
Practice Address - Street 1:1301 NORTHWEST HWY
Practice Address - Street 2:STE 206
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5896
Practice Address - Country:US
Practice Address - Phone:214-345-7786
Practice Address - Fax:214-345-2682
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132193363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health