Provider Demographics
NPI:1619179439
Name:HOWARD A. TOBIN MD, PA
Entity Type:Organization
Organization Name:HOWARD A. TOBIN MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-861-4688
Mailing Address - Street 1:6300 REGIONAL PLZ
Mailing Address - Street 2:SUITE 475
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5251
Mailing Address - Country:US
Mailing Address - Phone:325-695-3630
Mailing Address - Fax:325-695-3633
Practice Address - Street 1:6300 REGIONAL PLZ
Practice Address - Street 2:SUITE 475
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5251
Practice Address - Country:US
Practice Address - Phone:325-695-3630
Practice Address - Fax:325-695-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RN0300X
TX000111261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZ04510302Medicaid
45-1030Medicare ID - Type Unspecified