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Individual

STEVEN GLENN VAUGHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1301 MONTGOMERY RD, GRAHAM, TX 76450-4240
(520) 882-2172
(940) 521-5289
Mailing address
1301 MONTGOMERY RD, GRAHAM, TX 76450-4240
(940) 521-5412
(940) 521-5289

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29930
TX
208600000X
Surgery Physician
Primary
Q1761
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
401019101
TX
Enumeration date
12/28/2005
Last updated
12/28/2023
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