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General NPI Number Information
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NPI Number | 1720474240
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Entity Type | Individual
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Provider Name | JOSE I. TOVAR-CAMARGO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 4002 S LOOP 256
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City | PALESTINE
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State | TX
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Zip | 75801
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Country | US
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Telephone | 361-902-6570
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Fax | 361-881-1467
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Provider Business Mailing Address
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Address Line | 4002 S LOOP 256
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City | PALESTINE
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State | TX
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Zip | 75801-8491
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Country | US
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Telephone | 903-731-5030
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Fax | 903-731-5037
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R6121
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R6121
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License Number State | TX
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