Provider Demographics
NPI:1548331655
Name:PEGASUS QUEST, L.L.C.
Entity type:Organization
Organization Name:PEGASUS QUEST, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZINDA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:956-440-8658
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-0483
Mailing Address - Country:US
Mailing Address - Phone:956-440-8658
Mailing Address - Fax:956-440-1412
Practice Address - Street 1:1906 E TYLER AVE
Practice Address - Street 2:SUITE H
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7106
Practice Address - Country:US
Practice Address - Phone:956-440-8658
Practice Address - Fax:956-440-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136482100OtherVALLEY HEALTH PLAN