Individual
MR. TERRILL ANDREW VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
5012 US HWY 75 STE 300, DENISON, TX 75020-4589
(903) 416-6065
(903) 416-6068
Mailing address
8230 WALNUT HILL LN STE 514, DALLAS, TX 75231-4407
(214) 345-2929
(214) 345-2905
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
P42740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020HD
GROUP BCBS
TX
05
—
148913001
—
TX
01
—
8N3607
BCBS
TX
01
—
A005
TRICARE CHAMPUS
TX
05
—
PA03083
—
TX
Enumeration date
07/22/2005
Last updated
09/11/2024
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