Provider Demographics
NPI:1649287491
Name:VAUGHAN, ELIZABETH R (MD)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:R
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2811 LEMMON AVE E
Mailing Address - Street 2:STE 202
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:214-522-6380
Mailing Address - Fax:214-559-2471
Practice Address - Street 1:2811 LEMMON AVE E
Practice Address - Street 2:STE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-522-6380
Practice Address - Fax:214-559-2471
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD3425207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K833Medicare ID - Type Unspecified
C22936Medicare UPIN