Costilla, Brant Edward

Costilla, Brant Edward is an individual health care provider with primary practice located at 2112 Forum Pkwy , Bedford TX 76021-6028. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Costilla, Brant Edward can be contacted via phone (817) 799-4909.

Contact Information

Primary practice address
2112 Forum Pkwy Bedford TX 76021-6028
Phone: (817) 799-4909
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2131372 Texas

Profile Details

NPI number 1316554595
LBN Legal business name Costilla, Brant Edward
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2020
Last updated Sep 30th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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