Individual
GERARDO J. MOREIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.A.
Contact information
Practice address
1600 MONTANA AVE, EL PASO, TX 79902-5622
(915) 877-3410
(915) 351-3643
Mailing address
2415 E YANDELL DR, EL PASO, TX 79903-3616
(915) 577-0111
(915) 533-2568
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
J1320
TX
2084P0800X
Psychiatry Physician
Primary
J1320
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013935675
—
TX
05
—
1151755-02
—
TX
05
—
F28006
—
NM
01
—
TXB147437
MEDICARE
TX
Enumeration date
07/18/2006
Last updated
07/07/2025
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