Provider Demographics
NPI:1972605459
Name:VAUGHN, KAREN RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:RENEE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 GURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-2840
Mailing Address - Country:US
Mailing Address - Phone:325-428-7997
Mailing Address - Fax:254-651-1133
Practice Address - Street 1:903 NORTH IH35
Practice Address - Street 2:SUITE 112
Practice Address - City:BELLMEAD
Practice Address - State:TX
Practice Address - Zip Code:76705
Practice Address - Country:US
Practice Address - Phone:254-335-5844
Practice Address - Fax:254-651-1133
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9071208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009941474Medicaid
ALI32237OtherVIVA HEALTH
AL051004983OtherBLUE CROSS
AL721608375OtherMEDICARE COMPLETE
ALI32237Medicare UPIN
AL051558135Medicare ID - Type Unspecified