Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | F8354 | TX |
NPI | 1134208259 |
---|---|
Provider Name | Dr. Sylvester G Vaughns |
First Address | Richmond, TX 77469-5114 |
Second Address | Richmond, TX 77469-5114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 11/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138396004 | (05) | TX |
B27276 | (02) | TX |