Individual
ALTON WAYNE FUNDERBURK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(806) 212-5803
Mailing address
11884 MOORHEN CIR, FORT WORTH, TX 76244-7587
(214) 364-8028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
678869
TX
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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