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General NPI Number Information
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NPI Number | 1699429688
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Entity Type | Individual
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Provider Name | STEVEN MATTHEW FUNG-ON PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 5420 WEST LOOP S STE 1100
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City | BELLAIRE
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State | TX
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Zip | 77401-2115
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Country | US
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Telephone | 713-486-5590
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Fax |
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Provider Business Mailing Address
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Address Line | 3375 GRASSY LAKE VIEW AVE
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City | MINNEOLA
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State | FL
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Zip | 34715-6859
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Country | US
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Telephone | 954-298-7047
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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