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General NPI Number Information
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NPI Number | 1720609811
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Entity Type | Organization
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Legal Business Name | INTEGRATED NEUROLOGY AND NEUROPHYSIOLOGY OF NORTH TEXAS
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 521 W SOUTHLAKE BLVD STE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6173
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Country | US
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Telephone | 817-328-3000
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Fax | 827-328-3333
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Provider Business Mailing Address
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Address Line | 120 E FM 544 STE 72
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City | MURPHY
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State | TX
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Zip | 75094-4035
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Country | US
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Telephone | 972-422-0140
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Fax | 972-422-0140
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Authorized Official
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Title or Position | NEUROLOGIST
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Name | DR. JOSEPH K VAUGHAN JR.
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Credential | MD
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Telephone | 972-520-6535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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