Provider Demographics
NPI:1003041336
Name:KOSZTOWSKI, THOMAS ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ADAM
Last Name:KOSZTOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PARKER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8172
Mailing Address - Country:US
Mailing Address - Phone:469-782-0660
Mailing Address - Fax:469-782-0661
Practice Address - Street 1:4001 W 15TH ST STE 455
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5842
Practice Address - Country:US
Practice Address - Phone:469-782-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD15729207T00000X
TXR5418207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery