Provider Demographics
NPI:1891513768
Name:TOVANCHE, MOISES ENRIQUE (FNP-C)
Entity type:Individual
Prefix:
First Name:MOISES
Middle Name:ENRIQUE
Last Name:TOVANCHE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 VAUDEVILLE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5418
Mailing Address - Country:US
Mailing Address - Phone:915-226-9822
Mailing Address - Fax:
Practice Address - Street 1:601 E OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-2554
Practice Address - Country:US
Practice Address - Phone:915-546-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily