Provider Demographics
NPI:1912106949
Name:VAUGHN, RAY C (PA)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:C
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3821 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1569
Mailing Address - Country:US
Mailing Address - Phone:972-221-2784
Mailing Address - Fax:972-420-0499
Practice Address - Street 1:3821 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1569
Practice Address - Country:US
Practice Address - Phone:972-221-2784
Practice Address - Fax:972-420-0499
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03822207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology