Active NPI
Louis E. Costello, M.D., P.a.
- Child & Adolescent Psychiatry Physician
- Lewisville, TX
National Provider Identifier
1700112331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- J1950
- Legal business name
- LOUIS E. COSTELLO, M.D., P.A.
- Practice address
- 190 Civic Cir
Suite 250
Lewisville, TX 75067-3424 - Phone
- (972) 436-8591
- Fax
- (972) 221-6609
- NPI assigned
- Nov 2, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Velma Byford
- Title
- Claims Billing Specialist
- Phone
- (972) 979-7462
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | J1950 | TX | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | J1950 | TX | Primary |
Addresses
Primary practice location
190 Civic Cir
Suite 250
Lewisville, TX 75067-3424
Mailing address
190 Civic Cir
Suite 250
Lewisville, TX 75067-3424
Phone (972) 436-8591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113825702 | Medicaid | TX |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1258502400000",
"number": "1700112331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 CIVIC CIR",
"address_2": "SUITE 250",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673424",
"telephone_number": "972-436-8591",
"fax_number": "972-221-6609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 CIVIC CIR",
"address_2": "SUITE 250",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673424",
"telephone_number": "972-436-8591",
"fax_number": "972-221-6609"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOUIS E. COSTELLO, M.D., P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-02",
"last_updated": "2009-11-18",
"status": "A",
"authorized_official_last_name": "BYFORD",
"authorized_official_first_name": "VELMA",
"authorized_official_title_or_position": "CLAIMS BILLING SPECIALIST",
"authorized_official_telephone_number": "972-979-7462",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "J1950",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TX",
"license": "J1950",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113825702",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.