NPI 1629963780

Black-Pearl Medical LLC

Organisation Point of Service San Antonio, TX

Practice location

Address: 12407 Walthampton St, San Antonio, TX 78216-2944
Phone: (316) 992-0034
Mailing address: 8521 Blanco Rd STE 2, San Antonio, TX 78216-3069

Authorised official

Name: Juliet Makena Gatobu
Title: Owner
Phone: (254) 307-8218

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

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Registry record

NPI: 1629963780
Entity type: Organization
NPI issued: 10 Jun 2025
Record last updated: 29 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.