Healthcare Provider Details

I. General information

NPI: 1861108599
Provider Name (Legal Business Name): VAUGHN INTERNAL MEDICINE AND PEDIATRICS OF TEXAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/26/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 N. IH 35 SUITE 112
BELLMEAD TX
76705
US

IV. Provider business mailing address

2507 GURLEY AVE
WACO TX
76706-2840
US

V. Phone/Fax

Practice location:
  • Phone: 254-335-5844
  • Fax: 254-651-1133
Mailing address:
  • Phone: 325-428-7997
  • Fax: 254-651-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN VAUGHN
Title or Position: OWNER/SOLE MEMBER
Credential: MD
Phone: 325-428-7997