Provider Demographics
NPI:1154427722
Name:HELGESON, SCOTT L (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:HELGESON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S 10TH ST STE B6
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-5435
Mailing Address - Country:US
Mailing Address - Phone:956-682-4459
Mailing Address - Fax:956-630-4139
Practice Address - Street 1:2200 S 10TH ST STE B6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-5435
Practice Address - Country:US
Practice Address - Phone:956-682-4459
Practice Address - Fax:956-630-4139
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4482TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E50ZOtherBLUE CROSS/BLUE SHIELD
TX092994501Medicaid
00140EMedicare ID - Type Unspecified