Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Paul Mayombola, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1902283534

Paul Mayombola, AGACNP is a Nurse Practitioner in Dallas, Texas. Qualified in 2014, 12 years ago. Practices with Healthtexas Provider Network, a 2,539-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
12
Licensed in
TX
In the registry since
2015
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Practice location Address checks out

3500 Gaston Ave
Dallas, TX 75246-2017
Phone: (214) 820-6856
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence AP127876 (TX)

Record details

NPI number1902283534
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMay 4, 2015
Last updated in NPPESApril 5, 2022
Certification dateApril 5, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Healthtexas Provider Network — 2539 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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