Provider Demographics
NPI:1790789444
Name:GIANNONI, CARLA M (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:GIANNONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-798-5900
Mailing Address - Fax:713-798-5294
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:STE 540
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2316
Practice Address - Country:US
Practice Address - Phone:832-822-3250
Practice Address - Fax:832-825-3396
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2335207YP0228X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141986301Medicaid
G50195Medicare UPIN
TX83083JMedicare PIN
TX80003KMedicare PIN
TX8L1938Medicare PIN