Organization Active NPI

Louis E. Costello, M.D., P.a.

  • Child & Adolescent Psychiatry Physician
  • Lewisville, TX
National Provider Identifier
1700112331
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
J1950 Issued in TX
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

Updated by the provider on Nov 18, 2009

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X J1950 TX
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
113825702MedicaidTX

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.