Provider Demographics
NPI:1851688758
Name:GERKEN, NICHOLAS EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:EDWARD
Last Name:GERKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1139 E SONTERRA BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4987
Mailing Address - Country:US
Mailing Address - Phone:210-874-3359
Mailing Address - Fax:210-874-3369
Practice Address - Street 1:1139 E SONTERRA BLVD STE 401
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4987
Practice Address - Country:US
Practice Address - Phone:210-874-3359
Practice Address - Fax:210-874-3369
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4046207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery