Provider Demographics
NPI:1114981529
Name:PAXTON, RAYMOND C (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:C
Last Name:PAXTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 N MOPAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-334-2403
Mailing Address - Fax:512-334-2493
Practice Address - Street 1:1250 S CAPITAL OF TEXAS HWY BLDG 3
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6446
Practice Address - Country:US
Practice Address - Phone:512-334-2403
Practice Address - Fax:512-334-2493
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044027301Medicaid
TX8576K2Medicare PIN
TXH22260Medicare UPIN
TX110210885Medicare PIN