Provider Demographics
NPI:1962649665
Name:KONDURIS, HELEN FELICIA (MOTR CHT)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:FELICIA
Last Name:KONDURIS
Suffix:
Gender:F
Credentials:MOTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14439 NW MILITARY HWY STE 108
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1648
Mailing Address - Country:US
Mailing Address - Phone:210-976-1130
Mailing Address - Fax:
Practice Address - Street 1:818 KNIGHTS CROSS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2982
Practice Address - Country:US
Practice Address - Phone:210-557-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108854225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB136289Medicare PIN