| NPI | 1417691353 |
|---|---|
| Former Legal Business Name | PEGUS TELEMEDICINE PLLC |
| Former Legal Business Name | PULLURU TELEMEDICINE PLLC |
| Entity Type | Organization |
| Authorized Contact | MARK SHEN Owner 512-779-7276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-02-13 |