Individual
MICHAEL S VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
(817) 735-5441
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
(817) 735-5441
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E8217
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135468009
—
TX
05
—
135468010
—
TX
01
—
8CJ380
BCBS
TX
01
—
P00844635
RAILROAD MEDICARE
TX
Enumeration date
07/08/2006
Last updated
03/09/2012
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