Healthcare Provider Details

I. General information

NPI: 1174567705
Provider Name (Legal Business Name): REUBEN WENCIS TOVAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 RIALTO BLVD SUITE 140
AUSTIN TX
78735
US

IV. Provider business mailing address

7500 RIALTO BLVD SUITE 140
AUSTIN TX
78735
US

V. Phone/Fax

Practice location:
  • Phone: 512-730-3058
  • Fax: 888-685-0677
Mailing address:
  • Phone: 512-730-3058
  • Fax: 888-685-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD15177
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME114642
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ9928
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2022-00266
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberJ9928
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME114642
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2022-00266
License Number StateNC
# 8
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM-14178
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: