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Organization

ABILENE SPORTS MEDICINE & ORTHOPEDICS, PA

Active
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Organization

ABILENE SPORTS MEDICINE & ORTHOPEDICS, PA

Active
Other names
Dale Funk, M.D.
Organization subpart
No

Provider details

NPI number
Authorized official
DALE A. FUNK M.D. (OWNER)
(325) 698-3865
Entity
Organization

Contact information

Practice address
2074 ANTILLEY RD, ABILENE, TX 79606-5209
(325) 698-3865
(325) 793-1295
Mailing address
2074 ANTILLEY RD, ABILENE, TX 79606-5209
(325) 698-3865
(325) 793-1295

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J4131
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007LE
BCBS - GROUP
TX
01
123924
SUPERIOR HEALTHPLAN
TX
05
166283501
TX
Enumeration date
08/15/2006
Last updated
05/07/2008
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