Provider Demographics
NPI:1205185915
Name:GERNHOFER, YAN KO (DO)
Entity type:Individual
Prefix:
First Name:YAN
Middle Name:KO
Last Name:GERNHOFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:YAN
Other - Middle Name:
Other - Last Name:KO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2850
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1540
Mailing Address - Country:US
Mailing Address - Phone:713-486-5100
Mailing Address - Fax:713-512-7203
Practice Address - Street 1:6400 FANNIN ST STE 2850
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1540
Practice Address - Country:US
Practice Address - Phone:713-486-5100
Practice Address - Fax:713-512-7203
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
CA3848364SA2200X
CA22280363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHD9652OtherMEDICARE PTAN