Individual
RICHARD COSTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19337 MCDONALD ST, LYTLE, TX 78052-3622
(830) 772-5021
Mailing address
1955 MARTINEZ LOSOYA RD LOT 2, SAN ANTONIO, TX 78221-9743
(210) 537-2443
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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