Provider Demographics
NPI:1619281524
Name:VAUGHN, MICHAEL RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RYAN
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-5606
Mailing Address - Country:US
Mailing Address - Phone:254-698-1600
Mailing Address - Fax:254-698-1605
Practice Address - Street 1:560 E CENTRAL TEXAS EXPY
Practice Address - Street 2:SUITE 102
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5606
Practice Address - Country:US
Practice Address - Phone:254-698-1600
Practice Address - Fax:254-698-1605
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor