Provider Demographics
NPI:1174567705
Name:TOVAR, REUBEN WENCIS (MD)
Entity type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:WENCIS
Last Name:TOVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7500 RIALTO BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735
Mailing Address - Country:US
Mailing Address - Phone:512-730-3058
Mailing Address - Fax:888-685-0677
Practice Address - Street 1:7500 RIALTO BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735
Practice Address - Country:US
Practice Address - Phone:512-730-3058
Practice Address - Fax:888-685-0677
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD15177207R00000X
FLME114642207R00000X, 208M00000X
TXJ9928207R00000X, 208M00000X
NC2022-00266207R00000X, 208M00000X
IDM-14178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104965202Medicaid
TX1049652-02Medicaid
TX1049652-02Medicaid
TX104965202Medicaid
TXTXB122059Medicare PIN
TX86289NMedicare PIN
RIU400256892Medicare PIN
TXG46757Medicare UPIN