Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | M7980 | TX |
NPI | 1013193895 |
---|---|
Provider Name | Dr. Etai Funk |
First Address | Houston, TX 77024-2773 |
Second Address | Houston, TX 77024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 19/07/2018 |