Provider Demographics
NPI:1447298591
Name:SKERHUT, HOLGER EI (MD)
Entity type:Individual
Prefix:
First Name:HOLGER
Middle Name:EI
Last Name:SKERHUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 NE LOOP 410
Mailing Address - Street 2:STE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4659
Mailing Address - Country:US
Mailing Address - Phone:210-650-9022
Mailing Address - Fax:210-650-0254
Practice Address - Street 1:2130 NE LOOP 410
Practice Address - Street 2:STE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4659
Practice Address - Country:US
Practice Address - Phone:210-650-9022
Practice Address - Fax:210-650-0254
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6621207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081410501Medicaid
TX742783832OtherTIN
TXB26491Medicare UPIN
TX742783832OtherTIN