Provider Demographics
NPI:1366419863
Name:BIANCA, JOSEPH F (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:BIANCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:804 MEDICAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5109
Mailing Address - Country:US
Mailing Address - Phone:903-757-8140
Mailing Address - Fax:903-757-6915
Practice Address - Street 1:804 MEDICAL CIRCLE DR
Practice Address - Street 2:SUITE B
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5109
Practice Address - Country:US
Practice Address - Phone:903-757-8140
Practice Address - Fax:903-757-6915
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD5681207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
824424Medicare ID - Type Unspecified
TXC13449Medicare UPIN