Active NPI
Robert Vaughn
- Physical Therapist
- San Antonio, TX
National Provider Identifier
1295905859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1061703
- Practice address
- 115600 San Pedro Ave Ste 307
San Antonio, TX 78232 - Phone
- (210) 494-2343
- NPI assigned
- Mar 10, 2008
- Last updated
- Mar 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1061703 | TX | Primary |
Addresses
Primary practice location
115600 San Pedro Ave Ste 307
San Antonio, TX 78232
Mailing address
115600 San Pedro Ave Ste 307
San Antonio, TX 78232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1061703 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1295905859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115600 SAN PEDRO AVE STE 307",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115600 SAN PEDRO AVE STE 307",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78232",
"telephone_number": "210-494-2343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "ROBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1061703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.