Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | H7242 | TX |
NPI | 1881687879 |
---|---|
Provider Name | Dr. Michael Patrick Vaughn |
First Address | San Antonio, TX 78291-0156 |
Second Address | San Antonio, TX 78258-3388 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 18/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133677801 | (05) | TX |
167435001 | (05) | TX |
E82742 | (02) | TX |