MEDICARE: VERONICA MENA FUNKE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	32342	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588683643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA MENA FUNKE LCSW

Provider Business Mailing Address
First Line	:	4606 FM 1960 RD W STE 580
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4652
Country	:	US
Telephone Number	:	346-331-0321
Fax Number	:	281-466-4880

Provider Business Practice Location Address
First Line	:	4606 FM 1960 RD W STE 580
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4652
Country	:	US
Telephone Number	:	346-331-0321
Fax Number	:	281-466-4880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/31/2019

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