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Organization

HENRY COSTA, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HENRY COSTA M.D. (PRESIDENT)
(915) 592-6868
Entity
Organization

Contact information

Practice address
10555 VISTA DEL SOL DR, STE 120, EL PASO, TX 79925-7942
(915) 590-6770
(915) 590-6624
Mailing address
7812 GATEWAY BLVD E, STE 200, EL PASO, TX 79915-1803
(915) 592-6868
(915) 592-6889

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116754606
TX
01
DF4091
RAILROAD MEDICARE
Enumeration date
09/15/2006
Last updated
09/03/2010
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