Provider Demographics
NPI:1134408651
Name:HUERTA, GERARDO (OTR, CHT)
Entity type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:
Last Name:HUERTA
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN STE 248
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1671
Mailing Address - Country:US
Mailing Address - Phone:210-558-7025
Mailing Address - Fax:210-558-4762
Practice Address - Street 1:21 SPURS LN STE 248
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1671
Practice Address - Country:US
Practice Address - Phone:210-558-7025
Practice Address - Fax:210-558-4762
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TX109571225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist