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General NPI Number Information
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NPI Number | 1013193895
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Entity Type | Individual
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Provider Name | ETAI FUNK M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 952 ECHO LN STE 140
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City | HOUSTON
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State | TX
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Zip | 77024
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Country | US
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Telephone | 713-636-2757
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Fax | 281-888-4083
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Provider Business Mailing Address
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Address Line | 952 ECHO LN STE 140
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City | HOUSTON
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State | TX
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Zip | 77024-2773
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Country | US
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Telephone | 713-636-2757
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Fax | 281-888-4083
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | M7980
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License Number State | TX
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