Provider Demographics
NPI:1942404520
Name:NATIVIDAD, TORIBIO TOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:TORIBIO
Middle Name:TOMAS
Last Name:NATIVIDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10555 VISTA DEL SOL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7943
Mailing Address - Country:US
Mailing Address - Phone:915-594-5925
Mailing Address - Fax:915-594-5926
Practice Address - Street 1:10555 VISTA DEL SOL DR STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7943
Practice Address - Country:US
Practice Address - Phone:915-594-5925
Practice Address - Fax:915-594-5926
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0022233207X00000X
TXN8430207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB133416Medicare PIN
TX286368001Medicaid