MEDICARE: TENNEH JALLOH-ADENEGAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	16149	TX

General Provider Information

NPI Number	:	1912727454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENNEH JALLOH-ADENEGAN DC

Provider Business Mailing Address
First Line	:	4130 FM 762 RD STE 300
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77469-6436
Country	:	US
Telephone Number	:	281-771-0659
Fax Number	:

Provider Business Practice Location Address
First Line	:	10415 W GRAND PKWY S UNIT 120
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8718
Country	:	US
Telephone Number	:	281-816-3771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	10/10/2024

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