Provider Demographics
NPI:1861665069
Name:PEGASSUS THERAPY SERVICES, P.L.L.C
Entity Type:Organization
Organization Name:PEGASSUS THERAPY SERVICES, P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:VOULOUKOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OT
Authorized Official - Phone:337-288-5656
Mailing Address - Street 1:411 W SAINT ELMO RD
Mailing Address - Street 2:UNIT # 38
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3374
Mailing Address - Country:US
Mailing Address - Phone:337-288-5656
Mailing Address - Fax:512-373-3956
Practice Address - Street 1:411 W SAINT ELMO RD
Practice Address - Street 2:UNIT # 38
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3374
Practice Address - Country:US
Practice Address - Phone:337-288-5656
Practice Address - Fax:512-373-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171568261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy