Provider Demographics
NPI:1902561277
Name:SCALF, LETICIA (CHW)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:SCALF
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11026 INVIERNO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-2206
Mailing Address - Country:US
Mailing Address - Phone:832-235-9077
Mailing Address - Fax:
Practice Address - Street 1:6846 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1210
Practice Address - Country:US
Practice Address - Phone:713-510-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXOSQ4MARTFP172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker