Organization
DIVINE GRACE FAMILY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEYINKA ODAFEME OYEKUNLE (OWNER)
(502) 386-0112
Entity
Organization
Contact information
Practice address
2455 ROBINSON RD STE 100, GRAND PRAIRIE, TX 75051-3852
(469) 660-0032
Mailing address
2455 ROBINSON RD STE 100, GRAND PRAIRIE, TX 75051-3852
(469) 660-0032
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
04/05/2021
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