Provider Demographics
NPI:1780240879
Name:TOVAR, JOSE GILBERTO (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:GILBERTO
Last Name:TOVAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-0231
Mailing Address - Country:US
Mailing Address - Phone:956-605-3954
Mailing Address - Fax:956-687-2244
Practice Address - Street 1:5203 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-0231
Practice Address - Country:US
Practice Address - Phone:956-605-3954
Practice Address - Fax:956-687-2244
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist