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General NPI Number Information
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NPI Number | 1861665069
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Entity Type | Organization
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Legal Business Name | PEGASSUS THERAPY SERVICES, P.L.L.C
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 411 W SAINT ELMO RD UNIT # 38
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City | AUSTIN
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State | TX
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Zip | 78745-3374
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Country | US
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Telephone | 337-288-5656
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Fax | 512-373-3956
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Provider Business Mailing Address
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Address Line | 411 W SAINT ELMO RD UNIT # 38
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City | AUSTIN
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State | TX
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Zip | 78745-3374
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Country | US
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Telephone | 337-288-5656
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Fax | 512-373-3956
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS GEORGE VOULOUKOS
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Credential | P.T., O.T.
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Telephone | 337-288-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1171568
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License Number State | TX
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