Provider Demographics
NPI:1497440309
Name:VAUGHAN, ELENA NIKOL (DC)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:NIKOL
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 PLUM CT
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-1540
Mailing Address - Country:US
Mailing Address - Phone:469-975-9310
Mailing Address - Fax:
Practice Address - Street 1:9305 PLUM CT
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-1540
Practice Address - Country:US
Practice Address - Phone:469-975-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor