Provider Demographics
NPI:1083074793
Name:HELGE, ALVIN JR (PTA)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:HELGE
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-2123
Mailing Address - Country:US
Mailing Address - Phone:512-797-3451
Mailing Address - Fax:
Practice Address - Street 1:2109 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722-2123
Practice Address - Country:US
Practice Address - Phone:512-797-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2006813172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist