Provider Demographics
NPI:1447055538
Name:TOVAR, HUMBERTO TOBY IV
Entity type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:TOBY
Last Name:TOVAR
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 W STAN SCHLUETER LOOP STE 201
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-6120
Mailing Address - Country:US
Mailing Address - Phone:254-630-1578
Mailing Address - Fax:
Practice Address - Street 1:1605 GEORGE DIETER DR STE 308
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5686
Practice Address - Country:US
Practice Address - Phone:915-257-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician