Individual provider Active NPI

Etai Funk, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Houston, TX
National Provider Identifier
1013193895
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
M7980 Issued in TX
Practice address
952 Echo LN Ste 140
Houston, TX 77024
Phone
(713) 636-2757
Fax
(281) 888-4083
NPI assigned
Jan 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X M7980 TX Primary

Addresses

Primary practice location

952 Echo LN Ste 140
Houston, TX 77024

Mailing address

952 Echo LN Ste 140
Houston, TX 77024-2773
Phone (713) 636-2757

Other practice location 1

10575 Katy Fwy
230
Houston, TX 77024-1013
Phone (713) 636-2757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000263 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6901975226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Texas Medical School at Houston, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

952 Echo Lane
Houston, TX 77024-2773
Phone (713) 636-2757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fred J. Bressler, MD, PA PastSince Mar 25, 2008 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1013193895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 ECHO LN STE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242773",
            "telephone_number": "713-636-2757",
            "fax_number": "281-888-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 ECHO LN STE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-636-2757",
            "fax_number": "281-888-4083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10575 Katy Fwy",
            "address_2": "230",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770241013",
            "country_code": "US",
            "telephone_number": "713-636-2757",
            "fax_number": "281-888-4083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "ETAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "M7980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.