Provider Demographics
NPI:1801889894
Name:BROZEK, VAUGHN ANTHONY JR (FNP-C, DC)
Entity type:Individual
Prefix:DR
First Name:VAUGHN
Middle Name:ANTHONY
Last Name:BROZEK
Suffix:JR
Gender:M
Credentials:FNP-C, DC
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Mailing Address - Street 1:6245 RUFE SNOW DR STE 280-134
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-3349
Mailing Address - Country:US
Mailing Address - Phone:817-576-4828
Mailing Address - Fax:817-730-9096
Practice Address - Street 1:517 N CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5484
Practice Address - Country:US
Practice Address - Phone:214-518-6319
Practice Address - Fax:214-518-6396
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TXDC6838111N00000X
TXAP129778363L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No111N00000XChiropractic ProvidersChiropractor
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX854104OtherRN LICENSE
TXAP129778OtherNURSE PRACTIONER
TXAP129778OtherNURSE PRACTIONER
TXU64607Medicare UPIN