Individual
DR. ADAM J CZELUSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21310 PROVINCIAL BLVD, KATY, TX 77450-7580
(281) 599-0404
(281) 599-1655
Mailing address
21310 PROVINCIAL BLVD, KATY, TX 77450-7580
(281) 599-0404
(281) 599-1655
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
L5711
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159655302
—
TX
01
—
4325669
CIGNA
TX
01
—
7039471
AETNA
TX
01
—
8M9030
BCBS
TX
Enumeration date
08/02/2005
Last updated
09/21/2010
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