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NPI Code Detail

MEDICARE: RACHEL MARIE VAUGHAN PTA

MEDICARE: RACHEL MARIE VAUGHAN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2087692TX

General Provider Information

NPI Number : 1568945053
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL MARIE VAUGHAN PTA
Provider Business Mailing Address
First Line : 300 E BAKER ST
Second Line :
City : CLARKSVILLE
State : TX
Zip : 75426-5034
Country : US
Telephone Number : 903-427-2236
Fax Number : 903-427-5235
Provider Business Practice Location Address
First Line : 300 E BAKER ST
Second Line :
City : CLARKSVILLE
State : TX
Zip : 75426-5034
Country : US
Telephone Number : 903-427-2236
Fax Number : 903-427-5235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 09/11/2018

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Directions to “ RACHEL MARIE VAUGHAN PTA” Practice Location

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