Royal Haven Medical
NPI 1740895911ActiveOrganization· Nurse Practitioner, Primary Care· Mansfield, TX
Nurse Practitioner, Primary Care in Mansfield, Texas, registered in NPPES in September 2020. The authorized official on file is Paidamoyo Wagoneka, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1740895911 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 14, 2020 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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