Provider Demographics
NPI:1982368809
Name:TOVAR, TASHA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:MARIE
Last Name:TOVAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24193 COUNTY ROAD 2183 E
Mailing Address - Street 2:
Mailing Address - City:TATUM
Mailing Address - State:TX
Mailing Address - Zip Code:75691-3474
Mailing Address - Country:US
Mailing Address - Phone:903-399-5587
Mailing Address - Fax:
Practice Address - Street 1:620 TENAHA ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3404
Practice Address - Country:US
Practice Address - Phone:936-598-2716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily