Provider Demographics
NPI:1013193895
Name:FUNK, ETAI (MD)
Entity Type:Individual
Prefix:DR
First Name:ETAI
Middle Name:
Last Name:FUNK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 ECHO LN STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2773
Mailing Address - Country:US
Mailing Address - Phone:713-636-2757
Mailing Address - Fax:281-888-4083
Practice Address - Street 1:952 ECHO LN STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-636-2757
Practice Address - Fax:281-888-4083
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7980207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery