Basic Information
| Provider Information | |||||||||
| NPI: | 1720474240 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOVAR-CAMARGO | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | I. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4002 S LOOP 256 | ||||||||
| Address2: | |||||||||
| City: | PALESTINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 758018491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037315030 | ||||||||
| FaxNumber: | 9037315037 | ||||||||
| Practice Location | |||||||||
| Address1: | 4002 S LOOP 256 | ||||||||
| Address2: | |||||||||
| City: | PALESTINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619026570 | ||||||||
| FaxNumber: | 3618811467 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2015 | ||||||||
| LastUpdateDate: | 08/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R6121 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | R6121 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.