ADERONKE EFUNOGBON (NPI# 1407248875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407248875 |
| Entity Type | Individual |
| Full Name | ADERONKE EFUNOGBON |
| Practice Address |
1001 Matlock Rd Ste 105 Mansfield TX 76063 |
| Mailing Address |
1001 Matlock Rd Ste 105 Mansfield TX 76063-3443 |
| Practice Telephone | 8175923636 |
| Mailing Telephone | 8175923636 |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2019-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 51369 | TX | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5223 Villa Brook Ln, Arlington, TX 760177513 | 8173813861 |
| Street Address |
1001 MATLOCK RD STE 105 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414933 | Deramed Specialty Pharmacy | Pharmacy | 1001 Matlock Rd Ste 105, Mansfield, TX 76063-3443 | 2020-07-06 |
| 1164997169 | Derhann Co. LLC | Pharmacy | 1001 Matlock Rd Ste 105, Mansfield, TX 76063-3443 | 2018-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013951 | Travis Tuan Tran | Pharmacist | 1826 Lake Glen Trl, Mansfield, TX 76063-4090 | 2020-11-05 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1275170649 | Thi Thi Hoang Diep | Pharmacist | 503 Marquis Ln, Mansfield, TX 76063-9123 | 2019-12-04 |
| 1598317422 | Allisa Laford I | Pharmacist | 140 N Frontage Road, Within United Services Inc. Room 171, Mansfield, CT 06250-0625 | 2019-07-11 |
| 1629531421 | Sara Rebecca Pannell | Pharmacist | 3145 East Broad Street, Mansfield, TX 76063 | 2019-04-09 |
| 1477015691 | Kelsey Brianne Hickman | Pharmacist | 770 Balgreen Dr Ste 104, Mansfield, OH 44906-4106 | 2019-04-05 |
| 1811352784 | Lisa Marie Rivera | Pharmacist | 1600 Mallard Cir, Mansfield, TX 76063-4082 | 2015-12-20 |
| 1871964304 | Lilian Nyanganyi Momanyi | Pharmacist | 4303 Crestview Ln, Mansfield, TX 76063-8623 | 2015-10-09 |
| 1588031223 | Hieu-nam Nguyen | Pharmacist | 901 E Broad St, Mansfield, TX 76063 | 2015-08-28 |
| 1356718118 | Travis Rahe | Pharmacist | 865 Lexington Ave, Mansfield, OH 44907-1945 | 2015-08-27 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.