MEDICARE: MS. ELIZABETH R VAUGHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D3425	TX

General Provider Information

NPI Number	:	1649287491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH R VAUGHAN MD

Provider Business Mailing Address
First Line	:	2811 LEMMON AVE E
Second Line	:	STE 202
City	:	DALLAS
State	:	TX
Zip	:	75204
Country	:	US
Telephone Number	:	214-522-6380
Fax Number	:	214-559-2471

Provider Business Practice Location Address
First Line	:	2811 LEMMON AVE E
Second Line	:	STE 202
City	:	DALLAS
State	:	TX
Zip	:	75204
Country	:	US
Telephone Number	:	214-522-6380
Fax Number	:	214-559-2471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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