Provider Demographics
NPI:1376715904
Name:SCARELLA, JEFFREY EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:EDWARD
Last Name:SCARELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 DILBECK LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5351
Mailing Address - Country:US
Mailing Address - Phone:469-916-1592
Mailing Address - Fax:972-458-6829
Practice Address - Street 1:6060 DILBECK LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5351
Practice Address - Country:US
Practice Address - Phone:469-916-1592
Practice Address - Fax:972-458-6829
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor