Vaughn, Traci Lydricka

Vaughn, Traci Lydricka is an individual health care provider with primary practice located at 221 W Hickory Ave , Bastrop LA 71220-4551. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Vaughn, Traci Lydricka can be contacted via phone (318) 281-6111.

Contact Information

Primary practice address
221 W Hickory Ave Bastrop LA 71220-4551
Phone: (318) 281-6111
Fax: (318) 281-4429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 023914 Louisiana
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X M3777 Texas

Profile Details

NPI number 1902840697
LBN Legal business name Vaughn, Traci Lydricka
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Jan 8th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902840697 NPPES
Texas Other 8H8818 BLUE CROSS BLUE SHIELD

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