| Louis E. Costello, M.d., P.a. | |
|
190 Civic Cir Suite 250 Lewisville TX 75067-3424 | |
| (972) 436-8591 | |
| (972) 221-6609 |
| Full Name | Louis E. Costello, M.d., P.a. |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 190 Civic Cir, Lewisville, Texas |
| Authorized Official Name and Position | Velma Byford (CLAIMS BILLING SPECIALIST) |
| Authorized Official Contact | 9729797462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis E. Costello, M.d., P.a. 190 Civic Cir Suite 250 Lewisville TX 75067-3424 Ph: (972) 436-8591 | Louis E. Costello, M.d., P.a. 190 Civic Cir Suite 250 Lewisville TX 75067-3424 Ph: (972) 436-8591 |
| NPI Number | 1700112331 |
|---|---|
| Provider Enumeration Date | 11/02/2009 |
| Last Update Date | 11/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700112331 | NPI | - | NPPES |
| 113825702 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | J1950 (Texas) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | J1950 (Texas) | Primary |
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