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General NPI Number Information
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NPI Number | 1992643464
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Entity Type | Individual
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Provider Name | MAVERICK GAMALIEL FALLER PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 3333 RESEARCH PLZ
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City | SAN ANTONIO
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State | TX
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Zip | 78235-5154
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Country | US
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Telephone | 210-297-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4103 N LOOP 1604 W
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City | SAN ANTONIO
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State | TX
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Zip | 78249-1395
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Country | US
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Telephone | 210-572-8415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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