Provider Demographics
NPI:1043430416
Name:TOVAR, PAUL
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:TOVAR
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:PAULINO
Other - Middle Name:
Other - Last Name:TOVAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1701 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2712
Mailing Address - Country:US
Mailing Address - Phone:512-477-5731
Mailing Address - Fax:512-472-7549
Practice Address - Street 1:1701 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2712
Practice Address - Country:US
Practice Address - Phone:512-477-5731
Practice Address - Fax:512-472-7549
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist