Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 109571 | TX |
NPI | 1134408651 |
---|---|
Provider Name | Mr. Gerardo Huerta |
First Address | San Antonio, TX 78240-1679 |
Second Address | San Antonio, TX 78240-1679 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2011 |
Last Update Date | 15/08/2011 |