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Organization

FARAJA HEALTH SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL MAYOMBOLA DNP, AGACNP-BC (NURSE PRACTITIONER)
(214) 554-1945
Entity
Organization

Contact information

Practice address
5000 RIVERSIDE DR BLDG 6, IRVING, TX 75039-4316
(214) 554-1945
Mailing address
5923 SILVER SAGE LN, GRAND PRAIRIE, TX 75052-8748

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
363LA2100X
Acute Care Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner
363LG0600X
Gerontology Nurse Practitioner

Other

Enumeration date
10/16/2024
Last updated
10/09/2025
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