Provider Demographics
NPI:1366818205
Name:FUNK, DIANA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:FUNK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2256
Mailing Address - Country:US
Mailing Address - Phone:972-579-8155
Mailing Address - Fax:
Practice Address - Street 1:2001 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 550
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2256
Practice Address - Country:US
Practice Address - Phone:972-579-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1262636225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist