| Costello Clinic, P.a. | |
|
131 Degan Ave Suite 105 Lewisville TX 75057-3622 | |
| (972) 221-7006 | |
| (972) 353-5081 |
| Full Name | Costello Clinic, P.a. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 131 Degan Ave, Lewisville, Texas |
| Authorized Official Name and Position | Louis E Costello (PRESIDENT) |
| Authorized Official Contact | 9722217006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Costello Clinic, P.a. 131 Degan Ave Suite 105 Lewisville TX 75057-3622 Ph: (972) 221-7006 | Costello Clinic, P.a. 131 Degan Ave Suite 105 Lewisville TX 75057-3622 Ph: (972) 221-7006 |
| NPI Number | 1619073228 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619073228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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