Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Keller, TX
NPI 1558046300 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1558046300
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 800 Whitley Rd
Keller, TX 76248-2519 - Phone
- (800) 444-6845
- Fax
- (479) 478-2852
- NPI assigned
- Jun 20, 2023
- Organization subpart
- No
Authorized official
- Name
- Misty S Wilson
- Title
- Contract/Credentialing Specialist
- Phone
- (972) 372-6779
Other NPIs on the same Medicare enrollment 20
Corporate family (same tax ID) 21
Practitioners 4
-
Lara Pitt, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231018000657 | TX | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 69 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: McKinney, TX; North Richland Hills, TX; Plano, TX; Richardson, TX; San Antonio, TX; Mesquite, TX; Humble, TX; Keller, TX… |
National Provider Directory
- Tax ID family
- Aegis Group Practice
Locations
1860 N Cooper St
Arlington, TX 76011
Phone (469) 575-3312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
800 Whitley Rd
Keller, TX 76248-2519
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.