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Individual
MEGAN ELIZABETH FUNKHOUSER
Active
Individual
MEGAN ELIZABETH FUNKHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9699
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400979702
—
TX
01
—
400979703
CSHCN
TX
Enumeration date
06/13/2019
Last updated
12/09/2020
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