Organization · NPI-2

Aegis Group Practice LLC

Physical Therapist · Conroe, TX

NPI number1548945314

StatusActive

Last updated in NPPESJun 20, 2023

Details

NPI: 1548945314
Entity type: Organization (NPI-2)
Legal business name: Aegis Group Practice LLC
Organization subpart: No
Enumeration date: Jun 20, 2023
Certification date: Jun 20, 2023
Last updated: Jun 20, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	–	–	Yes
225X00000X	Occupational Therapist	–	–
235Z00000X	Speech-Language Pathologist,	–	–

Practice location

500 River Pointe Dr
Conroe, TX 77304-2802

Phone 800-444-6845 · Fax 479-478-2852

Mailing address

2601 Network Blvd Ste 102
Frisco, TX 75034-9092

Phone 972-372-6779 · Fax 479-668-0872

Authorized official

Misty S Wilson
Contract/Credentialing Specialist
9723726779

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