Individual provider Active NPI

Gabriela Moro

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1063108751
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
W4907 Issued in TX
Practice address
20642 Stone Oak Pkwy Ste 105
San Antonio, TX 78258-7363
Phone
(512) 324-0067
NPI assigned
Apr 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X W4907 TX Primary

Addresses

Primary practice location

20642 Stone Oak Pkwy Ste 105
San Antonio, TX 78258-7363

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260627000942 TX Practitioner - Pediatric Medicine 8729426630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3066 E Commerce St
San Antonio, TX 78220-1013

401 Fox Hall LN
San Antonio, TX 78213-1809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
W4907TXMDPediatrics Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1063108751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20642 STONE OAK PKWY STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587363",
            "telephone_number": "512-324-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORO",
        "first_name": "GABRIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "W4907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.