Healthcare Provider Details

I. General information

NPI: 1942276456
Provider Name (Legal Business Name): THOMAS CLAUDE VAUGHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 NORTH MOPAC BLDG I, SUITE 1200
AUSTIN TX
78731
US

IV. Provider business mailing address

6500 NORTH MOPAC BLDG I, SUITE 1200
AUSTIN TX
78731
US

V. Phone/Fax

Practice location:
  • Phone: 512-451-0149
  • Fax: 512-451-0977
Mailing address:
  • Phone: 512-451-0149
  • Fax: 512-451-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberE2912
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: