Individual provider Active NPI

Maverick Gamaliel Faller, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1992643464
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3333 Research PLZ
San Antonio, TX 78235-5154
Phone
(210) 297-3000
NPI assigned
Mar 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3333 Research PLZ
San Antonio, TX 78235-5154

Mailing address

4103 N Loop 1604 W
San Antonio, TX 78249-1395
Phone (210) 572-8415

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260508002973 TX Practitioner - Physician Assistant 3072081983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

111 Dallas St
San Antonio, TX 78205-1201
Phone (210) 297-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1992643464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 N LOOP 1604 W",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491395",
            "telephone_number": "210-572-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RESEARCH PLZ",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782355154",
            "telephone_number": "210-297-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLER",
        "first_name": "MAVERICK GAMALIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.