Provider Demographics
NPI:1497794630
Name:CIANCA, JOHN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:CIANCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5959 WEST LOOP S
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2421
Mailing Address - Country:US
Mailing Address - Phone:713-627-3156
Mailing Address - Fax:713-627-0393
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:713-627-3156
Practice Address - Fax:713-627-0393
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4747208100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610770Medicare PIN
TXF58746Medicare UPIN