NPI age
5 years
Enumerated 2020-09-29
● Active Type 2 · Organization
East Texas Functional Medicine Center, Llc
East Texas Functional Medicine Center, Llc is 1 of 154 preventive medicine organizations in Texas.
Primary specialty
Preventive Medicine
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Danielson
Md/owner
Last NPPES update
2020-12-07
Source: monthly bulk 2026-05
How this organization compares
Across 154 active preventive medicine providers in Texas.
NPI age
5 years
↓ 11 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 33% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-09Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
419 Wsw Loop 323 Ste 400
Tyler, TX 757017063
Mailing address
419 Wsw Loop 323 Ste 400
Tyler, TX 757017063
Authorized official
Guy Otis Danielson, MD
Md/owner
📞 9035958077
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Bradley Fisher, FNP-C Nurse Practitioner NPI 1033703749
Specialties
-
Preventive Medicine PrimaryPublic health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with...
-
Internal MedicineA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1801905674 | DR. DANIELSON'S NPI NUMBER |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Integrative Health Matters
-
Integrative Health Matters
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.