Organization
COSTELLO CLINIC, P.A.
Active
Organization
COSTELLO CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS E COSTELLO M.D. (PRESIDENT)
(972) 221-7006
Entity
Organization
Contact information
Practice address
131 DEGAN AVE, SUITE 105, LEWISVILLE, TX 75057-3622
(972) 221-7006
(972) 353-5081
Mailing address
131 DEGAN AVE, SUITE 105, LEWISVILLE, TX 75057-3622
(972) 221-7006
(972) 353-5081
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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