Healthcare Provider Details

I. General information

NPI: 1972605459
Provider Name (Legal Business Name): KAREN RENEE VAUGHN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 NORTH IH35 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 NumberM9071
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM9071
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: