Provider Demographics
NPI:1003068800
Name:BOYNTON, DILLON LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:DILLON
Middle Name:LEE
Last Name:BOYNTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 GATEWAY BLVD E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1275
Mailing Address - Country:US
Mailing Address - Phone:915-592-1011
Mailing Address - Fax:
Practice Address - Street 1:8080 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1275
Practice Address - Country:US
Practice Address - Phone:915-592-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7313T152W00000X
NV662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist