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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLACK-PEARL MEDICAL LLC
NPI 1629963780
Point of Service in San Antonio, TX

Active since June 10, 2025
12407 WALTHAMPTON ST, SAN ANTONIO, TX 78216(316) 992-0034 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2026, Sep 9, 2025, Jun 10, 2025 (3 updates tracked since 2025).

About Black-pearl Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK-PEARL MEDICAL LLC (NPI 1629963780) is a healthcare organization registered as a point of service in San Antonio, Texas and active in the NPI registry since June 2025. The organization lists Juliet Makena Gatobu, Owner, as its authorized official.

NPPES Registry Identity

NPI1629963780
Entity TypeOrganization
Primary Taxonomy305S00000X
Legal Business NameBLACK-PEARL MEDICAL LLC
Location Address12407 WALTHAMPTON STSan Antonio, TX 78216-2944
Mailing Address8521 Blanco Rd Ste 2San Antonio, TX 78216-3069 · (254) 307-8218 · Fax (888) 830-4526
Phone(316) 992-0034
Organization SubpartNo
Authorized OfficialJuliet Makena GatobuOwner · (254) 307-8218
Enumeration DateJune 10, 2025
Last NPPES UpdateJuly 29, 20263 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1629963780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations
Taxonomy Code305S00000X
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
12407 WALTHAMPTON ST, San Antonio, TX 78216
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Other Identifiers 1

Medicaid1629963780TX

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black-Pearl Medical LLC's NPI number?

The NPI number for Black-Pearl Medical LLC is 1629963780. It was assigned to this organization in the NPPES registry on June 10, 2025.

Where is Black-Pearl Medical LLC located?

Black-Pearl Medical LLC is located at 12407 Walthampton St, San Antonio, TX 78216. The listed phone number is (316) 992-0034.

What is Black-Pearl Medical LLC's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

When was this NPI record last updated?

The NPPES record for Black-Pearl Medical LLC was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.