Active NPI
Michael Funke, M.D.
- Pediatric Adolescent Medicine Physician
- Houston, TX
National Provider Identifier
1497167969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 44459
- Practice address
- 6410 Fannin St
Suite 732
Houston, TX 77030-3000 - Phone
- (713) 500-7103
- Fax
- (713) 500-0530
- NPI assigned
- Jun 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 44459 | TX | Primary |
Addresses
Primary practice location
6410 Fannin St
Suite 732
Houston, TX 77030-3000
Mailing address
6410 Fannin St
Suite 732
Houston, TX 77030-3000
Phone (713) 500-7103
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44459 | Other | TX | TEMPORARY INSTITUTIONAL LICENSE, TEXAS MEDICAL BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46259 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1497167969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6410 FANNIN ST",
"address_2": "SUITE 732",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303000",
"telephone_number": "713-500-7103",
"fax_number": "713-500-0530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 FANNIN ST",
"address_2": "SUITE 732",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303000",
"telephone_number": "713-500-7103",
"fax_number": "713-500-0530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNKE",
"first_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-02",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "TX",
"license": "44459",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEMPORARY INSTITUTIONAL LICENSE, TEXAS MEDICAL BOARD",
"identifier": "44459",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.