CORY NATHAN COSTELLO (NPI# 1861560138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861560138 |
| Entity Type | Individual |
| Full Name | CORY NATHAN COSTELLO |
| Credential | M.D. |
| Practice Address |
4800 Hedgcoxe Rd Ste 200 Plano TX 75024-2402 |
| Practice Telephone | 4698006120 |
| Practice Fax Number | 4698006129 |
| Mailing Telephone | 4698006120 |
| Mailing Fax Number | 4698006129 |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2020-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | S3145 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 34362 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS MEDICAL BOARD | S3145 | 01 |
| TN | STATE LICENSE | 34362 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 550 Pope Ave, Munson Army Health Center, Ms. Cotton, Credentials, Fort Leavenworth, KS 660272332 | 9136846562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477078244 | Cory Lyn Costello | Massage Therapist | 1601 2nd Ave N Ste 516, Great Falls, MT 59401-3289 | 2017-08-13 |
| Street Address |
4800 HEDGCOXE RD STE 200 |
| City | PLANO |
| State | TX |
| Zip Code | 75024-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689294605 | Seungeun Szczechowski | Specialist/Technologist, Other | 8308 Preston Rd Bldg 200, Suite 259, Plano, TX 75024 | 2020-04-20 |
| 1366080962 | Eating Recovery Center of Texas, LLC | Clinic/Center | 5120 Legacy Dr, Plano, TX 75024 | 2019-12-13 |
| 1336786615 | Regenerative Practitioners Group | Preventive Medicine | 8200 Preston Road Suite 100, Plano, TX 75024 | 2019-12-05 |
| 1033671771 | Cvs Pharmacy Inc. | Pharmacy | 6125 Legacy Drive, Plano, TX 75024 | 2019-04-02 |
| 1902364581 | Bayada Home Health Care, Inc. | Home Health | 5851 Legacy Circle, Fl 6, Suite 6052, Plano, TX 75024 | 2019-03-04 |
| 1881168052 | Waking Up To Peace Solutions LLC | Counselor | 8105 Rasor Blvd, Ste 303, Plano, TX 75024 | 2019-01-21 |
| 1407325905 | Fresenius Medical Care Willow Bend, LLC | Clinic/Center | 6823 Communications Pkwy Bldg A, Plano, TX 75024 | 2018-11-14 |
| 1265933378 | Cody Jones | Physical Therapist | 7211 Preston Road, Plano, TX 75024 | 2018-02-23 |
| 1720587538 | Sol Medical Massage Inc | Massage Therapist | 4666 Mcdermott Rd Suite 100, Plano, TX 75024 | 2018-02-07 |
| 1447768726 | Thelma Franco | Counselor | 5151 Headquarters Dr Ste 155, Plano, TX 75024 | 2018-01-20 |
| Find all providers in zip 75024 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427671981 | Staying Healthy Wellness LLC | Family Medicine | 4700 Dexter Dr Ste 300b, Plano, TX 75093-5294 | 2020-05-19 |
| 1124672811 | Stephen Twyman Md Pllc | Family Medicine | 5700 Tennyson Pkwy Ste 300, Plano, TX 75024-3595 | 2019-07-30 |
| 1073008827 | James D Cable Medical Pllc | Family Medicine | 6020 W Parker Rd Ste 425, Plano, TX 75093-8174 | 2018-06-25 |
| 1609389881 | Nortex Integrated Medicine Pllc | Family Medicine | 1200 Coit Rd Ste 109, Plano, TX 75075-7756 | 2017-11-10 |
| 1124558861 | Mw Wellness Vi, LLC | Family Medicine | 1921 Preston Rd Ste 2008, Plano, TX 75093-5200 | 2017-06-15 |
| 1013455443 | Nortex Integrated Medicine Pllc - Dallas Series | Family Medicine | 7000 Preston Rd Ste 1500, Plano, TX 75024-2512 | 2017-02-06 |
| 1649720509 | Stream Health Care Pa | Family Medicine | 280 Legacy Dr Ste 106, Plano, TX 75023-2315 | 2016-10-04 |
| 1588026330 | Vora Physicians, Pllc | Family Medicine | 1360 Star Ct, T1, Plano, TX 75074-7353 | 2016-03-22 |
| 1538543178 | Shssjv1 LLC | Family Medicine | 6400 Pinecrest Dr, Ste 300, Plano, TX 75024-2960 | 2015-07-14 |
| 1942606736 | Ntx Catalyst Health Network Inc | Family Medicine | 5212 Tennyson Pkwy, Suite 100, Plano, TX 75024-4211 | 2014-11-06 |
| Find all providers in PLANO | ||||
Please comment or provide details below to improve the information on CORY NATHAN COSTELLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.