Provider Demographics
NPI:1649497629
Name:ROSHEK, THOMAS BANCROFT III (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BANCROFT
Last Name:ROSHEK
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 LEGACY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3373
Mailing Address - Country:US
Mailing Address - Phone:972-494-3100
Mailing Address - Fax:972-608-0005
Practice Address - Street 1:5000 LEGACY DR STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3373
Practice Address - Country:US
Practice Address - Phone:972-494-3100
Practice Address - Fax:972-608-0005
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5980208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery