Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 109957 | TX |
N | 225XE1200X | Ergonomics | 109957 | TX |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 109957 | TX |
NPI | 1902922370 |
---|---|
Provider Name | Mr. Gerald J Hanke |
First Address | San Antonio, TX 78232-5024 |
Second Address | San Antonio, TX 78219-2333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 19/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TXB120397 | (02) | TX |