Individual
PETER A SIRIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2026 S JACKSON ST, JACKSONVILLE, TX 75766-5822
(903) 541-4613
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K3472
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
K3472
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103969505
—
TX
01
—
75-2616977-006
TRICARE
TX
01
—
752616977103
TRICARE
TX
Enumeration date
03/13/2007
Last updated
10/14/2014
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