Provider Demographics
NPI:1316351646
Name:VAUGHAN, KRISTIN WILLIAMS (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:WILLIAMS
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:DANIELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:315 N SAN SABA STE 1003
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3100
Mailing Address - Country:US
Mailing Address - Phone:210-704-3718
Mailing Address - Fax:
Practice Address - Street 1:315 N SAN SABA STE 1003
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3100
Practice Address - Country:US
Practice Address - Phone:210-704-3718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-14
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2253208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics