Provider Demographics
NPI:1952478232
Name:TODD, LUIS A (LUIS A TODD, MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:TODD
Suffix:
Gender:M
Credentials:LUIS A TODD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5628 EAGLE POINT ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6426
Mailing Address - Country:US
Mailing Address - Phone:915-345-2749
Mailing Address - Fax:
Practice Address - Street 1:12371 EDGEMERE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4878
Practice Address - Country:US
Practice Address - Phone:915-856-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0700208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice