Provider Demographics
NPI:1275268435
Name:TOVAR, FERNANDO (FIRST RESPONDER ECA)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:TOVAR
Suffix:
Gender:M
Credentials:FIRST RESPONDER ECA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7716
Mailing Address - Country:US
Mailing Address - Phone:956-720-8220
Mailing Address - Fax:
Practice Address - Street 1:108 W 20TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7716
Practice Address - Country:US
Practice Address - Phone:956-351-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343800000X
TX15907278343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)