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Individual

PAUL A VAUGHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9080 HARRY HINES BLVD, STE 110, DALLAS, TX 75235-1720
(214) 631-7880
(214) 631-7558
Mailing address
9080 HARRY HINES BLVD, STE 110, DALLAS, TX 75235-1720
(214) 631-7880
(214) 631-7558

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
H6973
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00D08P
BLUE CROSS BLUE SHIELD
TX
05
0325938-01
TX
01
TXB117214
MEDICARE GROUP PTAN
TX
01
TXB117215
MEDICARE PTAN
TX
Enumeration date
10/10/2006
Last updated
03/31/2011
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