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Individual

DR. DENNIS JAMES COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2790 LAKE VISTA DR, LEWISVILLE, TX 75067-3884
(972) 459-1300
(972) 459-1382
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
H5160
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137791301
TX
05
137791303
TX
05
137791304
TX
05
137791305
TX
05
137791306
TX
05
137791307
TX
05
137791308
TX
05
137791309
TX
05
137791311
TX
01
8R1416
BLUE CROSS OF TEXAS
TX
Enumeration date
06/02/2006
Last updated
08/25/2017
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