MEDICARE: GERARDO J. MOREIRA M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	J1320	TX
2	2084P0800X	Psychiatry Physician	J1320	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	TXB147437	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013935675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERARDO J. MOREIRA M.D., P.A.

Provider Business Mailing Address
First Line	:	2415 E YANDELL DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903-3616
Country	:	US
Telephone Number	:	915-577-0111
Fax Number	:	915-533-2568

Provider Business Practice Location Address
First Line	:	1600 MONTANA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5622
Country	:	US
Telephone Number	:	915-877-3410
Fax Number	:	915-351-3643

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/07/2025

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Directions to “ GERARDO J. MOREIRA M.D., P.A.” Practice Location

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