OrganizationActive
Black-Pearl Medical LLC
NPI 1629963780 · Point of Service · San Antonio, TX
Provider details
- NPI number
- 1629963780
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Juliet Gatobu, Owner(316) 992-0034
Specialties & taxonomies
Managed Care Organizations
Practice location
12407 Walthampton St
San Antonio, TX 78216-2944
Phone: (316) 992-0034
Approximate (ZIP-level) locationGet directions
Mailing address
12407 Walthampton St
San Antonio, TX 78216-2944
Registry dates
- Enumerated
- 2025-06-10
- Last updated
- 2025-09-09
- Certified
- 2025-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.