Provider Demographics
NPI:1720474240
Name:TOVAR-CAMARGO, JOSE I (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:I
Last Name:TOVAR-CAMARGO
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 1:4002 S LOOP 256
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-8491
Mailing Address - Country:US
Mailing Address - Phone:903-731-5030
Mailing Address - Fax:903-731-5037
Practice Address - Street 1:4002 S LOOP 256
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801
Practice Address - Country:US
Practice Address - Phone:361-902-6570
Practice Address - Fax:361-881-1467
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6121207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine