MEDICARE: PAUL A VAUGHAN, MD, PA

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	H6973	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB117214	OTHER	TX	MEDICARE GROUP PTAN
3	TXB117215	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790932960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL A VAUGHAN, MD, PA

Provider Business Mailing Address
First Line	:	9080 HARRY HINES BLVD
Second Line	:	SUITE 110
City	:	DALLAS
State	:	TX
Zip	:	75235-1720
Country	:	US
Telephone Number	:	214-631-7880
Fax Number	:	214-631-7558

Provider Business Practice Location Address
First Line	:	9080 HARRY HINES BLVD
Second Line	:	SUITE 110
City	:	DALLAS
State	:	TX
Zip	:	75235-1720
Country	:	US
Telephone Number	:	214-631-7880
Fax Number	:	214-631-7558

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL A VAUGHAN
Credential	:	MD
Telephone Number	:	214-631-7880

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	03/31/2011

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Directions to “PAUL A VAUGHAN, MD, PA ” Practice Location

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