Healthcare Provider Details
I. General information
NPI: 1306157672
Provider Name (Legal Business Name): VAUGHNS FAMILY CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2010
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 DOWLING DR
RICHMOND TX
77469-5114
US
IV. Provider business mailing address
2000 DOWLING DR
RICHMOND TX
77469-5114
US
V. Phone/Fax
- Phone: 281-342-1126
- Fax: 281-342-0548
- Phone: 281-342-1126
- Fax: 281-342-0548
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SYLVESTER
G.
VAUGHNS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-342-1126