Provider Demographics
NPI:1164484333
Name:SCALFANO, LAURA H (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:SCALFANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 W PARKER RD
Mailing Address - Street 2:ST. 324
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8100
Mailing Address - Country:US
Mailing Address - Phone:972-403-5437
Mailing Address - Fax:972-403-5438
Practice Address - Street 1:6300 W PARKER RD
Practice Address - Street 2:ST. 324
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8100
Practice Address - Country:US
Practice Address - Phone:972-403-5437
Practice Address - Fax:972-403-5438
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1659208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G34864Medicare UPIN