Organization
LOUIS E. COSTELLO, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VELMA BYFORD (CLAIMS BILLING SPECIALIST)
(972) 979-7462
Entity
Organization
Contact information
Practice address
190 CIVIC CIR, SUITE 250, LEWISVILLE, TX 75067-3424
(972) 436-8591
(972) 221-6609
Mailing address
190 CIVIC CIR, SUITE 250, LEWISVILLE, TX 75067-3424
(972) 436-8591
(972) 221-6609
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
J1950
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
J1950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113825702
—
TX
Enumeration date
11/02/2009
Last updated
11/18/2009
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