Provider Demographics
NPI:1831114065
Name:PAXTON, TODD L (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:L
Last Name:PAXTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 LAKEPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6469
Mailing Address - Country:US
Mailing Address - Phone:800-835-2362
Mailing Address - Fax:
Practice Address - Street 1:1945 LAKEPOINTE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6469
Practice Address - Country:US
Practice Address - Phone:800-835-2362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093834207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093834Medicaid
ILG33959Medicare UPIN
ILK36421Medicare PIN