Provider Demographics
NPI:1134208259
Name:VAUGHNS, SYLVESTER G (MD)
Entity type:Individual
Prefix:DR
First Name:SYLVESTER
Middle Name:G
Last Name:VAUGHNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 DOWLING DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5114
Mailing Address - Country:US
Mailing Address - Phone:281-342-1126
Mailing Address - Fax:281-342-0548
Practice Address - Street 1:2000 DOWLING DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5114
Practice Address - Country:US
Practice Address - Phone:281-342-1126
Practice Address - Fax:281-342-0548
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8354207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138396004Medicaid
TXB27276Medicare UPIN
TXTXBIO4801Medicare PIN