Healthcare Provider Details

I. General information

NPI: 1801685433
Provider Name (Legal Business Name): PAXTEN VAN HOUTEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E MILITARY AVE STE 220
FREMONT NE
68025-5433
US

IV. Provider business mailing address

4433 S 70TH ST STE 200
LINCOLN NE
68516-4275
US

V. Phone/Fax

Practice location:
  • Phone: 531-666-0251
  • Fax: 402-552-4900
Mailing address:
  • Phone: 402-443-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: