Healthcare Provider Details

I. General information

NPI: 1164484333
Provider Name (Legal Business Name): LAURA H SCALFANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 W PARKER RD ST. 324
PLANO TX
75093-8100
US

IV. Provider business mailing address

6300 W PARKER RD ST. 324
PLANO TX
75093-8100
US

V. Phone/Fax

Practice location:
  • Phone: 972-403-5437
  • Fax: 972-403-5438
Mailing address:
  • Phone: 972-403-5437
  • Fax: 972-403-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK1659
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: