Individual
RAYMOND M COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3600 MEMORIAL BLVD, SOUTH TEXAS VETERANS HEALTH CARE SYSTEM, KERRVILLE, TX 78028
(830) 370-6769
(830) 792-2474
Mailing address
3600 MEMORIAL BLVD, SOUTH TEXAS VETERANS HEALTH CARE SYSTEM, KERRVILLE, TX 78028
(830) 370-6769
(830) 792-2474
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-0916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114314103
—
TX
Enumeration date
08/24/2006
Last updated
07/30/2012
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