Individual
LOUIS E COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 CIVIC CIR STE 250, LEWISVILLE, TX 75067-3648
(972) 436-8591
(972) 221-6609
Mailing address
3119 OVERLOOK CIR, HIGHLAND VILLAGE, TX 75077-1840
(972) 221-7006
(972) 353-5081
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J1950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113825702
—
TX
Enumeration date
09/15/2006
Last updated
09/28/2009
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