TRACI VAUGHN, M.D., P.A.
Medical Practice at Harrison St, Beaumont, TX

License number
Texas M3777
Category
Medical Practice
Type
Otolaryngology
License number
Texas 023914
Category
Medical Practice
Type
Otolaryngology
Owner
Name: TRACI L VAUGHN M.D.
Title: DIRECTOR
Phone: (409) 923-1610
Address
Address
2955 Harrison St SUITE 204, Beaumont, TX 77702
National Provider ID: 1457593626
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TRACI VAUGHN, M.D., PA

Beaumont, TX

Status:
Inactive
Doing business as:
Traci Vaughn, M.D., PA
Registration:
Dec 10, 2008
Addresses:
2955 Harrison St STE 204, Beaumont, TX 77702 (Mailing)
Park Medical BLDG 1, Beaumont, TX 77702
State ID:
0801061388
Business type:
Professional Association
Office Managers:
Traci Vaughn Director, Medical Doctor, Member, Secretary, Treasurer, Vice-President, President, inactive,Alyencia Mack Office Manager, inactive
TIN:
32038490242

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