Individual
THOMAS COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2020 PALOMINO LN, SUITE 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Mailing address
2020 PALOMINO LN, SUITE # 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5527
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477590560
—
CA
05
—
200290011
—
NV
05
—
200470490A
—
OK
Enumeration date
05/31/2006
Last updated
01/13/2015
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