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Individual

JUSTIN COSTELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3851 ROGER BROOKE DRIVE, FORT SAM HOUSTON, SAN ANTONIO, TX 78234-6200
(210) 916-5545
Mailing address
3851 ROGER BROOKE DRIVE, FORT SAM HOUSTON, SAN ANTONIO, TX 78234-6200

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
973
NE

Other

Enumeration date
03/03/2011
Last updated
02/02/2022
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