Healthcare Provider Details
I. General information
NPI: 1154995603
Provider Name (Legal Business Name): AEGIS GROUP PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2021
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5156 N BEND XING
CINCINNATI OH
45247-3106
US
IV. Provider business mailing address
2601 NETWORK BLVD STE 102
FRISCO TX
75034-9092
US
V. Phone/Fax
- Phone: 800-444-6845
- Fax:
- Phone: 972-372-6779
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRITT
JEFFCOAT
Title or Position: SENIOR VP
Credential:
Phone: 972-372-6799