Provider Demographics
NPI:1639205669
Name:BRETT DANIEL SCALLY
Entity Type:Organization
Organization Name:BRETT DANIEL SCALLY
Other - Org Name:TEXAS HOME CARE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-398-5020
Mailing Address - Street 1:20219 AMBERLIGHT LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5077
Mailing Address - Country:US
Mailing Address - Phone:281-398-5020
Mailing Address - Fax:281-578-5436
Practice Address - Street 1:20219 AMBERLIGHT LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5077
Practice Address - Country:US
Practice Address - Phone:281-398-5020
Practice Address - Fax:281-578-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010408251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679620Medicare Oscar/Certification