# AEGIS GROUP PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306336565
- **Authorized official:** MISTY S WILSON (CONTRACT/CREDENTIALING)
- **Authorized official phone:** (972) 372-6779

## Contact information

- **Practice address:** 861 CRITTER CT, ONALASKA, WI 54650-8689
- **Practice address phone:** (800) 444-6845
- **Practice address fax:** (479) 478-2852
- **Mailing address:** 2601 NETWORK BLVD STE 102, FRISCO, TX 75034-9092
- **Mailing address phone:** (972) 372-6779
- **Mailing address fax:** (479) 668-0872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 05/14/2018
- **Last updated:** 09/15/2022