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Individual

MRS. L DENISE JOHNSON VAUGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
500 MEDICAL CENTER BLVD, WEBSTER, TX 77598-4220
(281) 338-3708
Mailing address
503 HARBORSIDE WAY, KEMAH, TX 77565-2252
(281) 745-7276

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
657031
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1154340982
TRICARE SOUTH
TX
05
142133110
TX
05
142133111
TX
01
8Y1578
BCBSTX PROVIDER NO.
TX
Enumeration date
07/19/2006
Last updated
05/14/2010
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