Provider Demographics
NPI:1902922370
Name:HANKE, GERALD J (OTR)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:J
Last Name:HANKE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
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Mailing Address - Street 1:1045 CENTRAL PARKWAY NORTH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5024
Mailing Address - Country:US
Mailing Address - Phone:210-541-4500
Mailing Address - Fax:210-541-4508
Practice Address - Street 1:3453 IH 35 N
Practice Address - Street 2:SUITE 207B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-2333
Practice Address - Country:US
Practice Address - Phone:210-587-4606
Practice Address - Fax:210-298-2658
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX109957225XE1200X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120397Medicare UPIN