Basic Information
| Provider Information | |||||||||
| NPI: | 1134408651 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUERTA | ||||||||
| FirstName: | GERARDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 SPURS LN STE 310 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105587025 | ||||||||
| FaxNumber: | 2105584664 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 SPURS LN STE 310 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105587025 | ||||||||
| FaxNumber: | 2105584664 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2011 | ||||||||
| LastUpdateDate: | 08/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 109571 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.