Provider Demographics
NPI:1194762567
Name:MILANI, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:MILANI
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 1:2120 N MACARTHUR BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2221
Mailing Address - Country:US
Mailing Address - Phone:972-438-4636
Mailing Address - Fax:972-438-6585
Practice Address - Street 1:2120 N MACARTHUR BLVD
Practice Address - Street 2:STE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2221
Practice Address - Country:US
Practice Address - Phone:972-438-4636
Practice Address - Fax:972-438-6585
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1824207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157141601Medicaid
TX157141601Medicaid
TX8644B6Medicare PIN