INTEGRATIVE HEALTH MATTERS
NPI 1245847672
Preventive Medicine - Public Health & General Preventive Medicine in Tyler, TX

Q: What is East Texas Functional Medicine Center, LLC's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Public Health & General Preventive Medicine, with taxonomy code 2083P0901X.

Active since September 29, 2020CLIA 45D2174553 · Waiver

419 WSW LOOP 323 STE 400, TYLER, TX 75701(903) 595-8077(903) 363-1541 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 7, 2020, Sep 29, 2020 (2 updates tracked since 2020).

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About Integrative Health Matters NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTEGRATIVE HEALTH MATTERS (NPI 1245847672) is a healthcare organization registered as a public health & general preventive medicine in Tyler, Texas and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through November 4, 2027 and lists Guy Otis Danielson, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1245847672

Entity TypeOrganization

Primary Taxonomy2083P0901X

Legal Business NameEAST TEXAS FUNCTIONAL MEDICINE CENTER, LLC

Location Address419 WSW LOOP 323 STE 400Tyler, TX 75701-7063

Mailing Address419 Wsw Loop 323 Ste 400Tyler, TX 75701-7063 · (903) 595-8077

Phone(903) 595-8077

Fax(903) 363-1541

Organization SubpartNo

Authorized OfficialGuy Otis DanielsonMd/owner · (903) 595-8077

Enumeration DateSeptember 29, 2020

Last NPPES UpdateDecember 7, 20202 updates tracked since enumeration

NPPES CertifiedDecember 7, 2020

✔ NPI 1245847672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Public Health & General Preventive MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083P0901X

Definition

Public 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 knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.

Also ListedInternal MedicineTaxonomy 207R00000X

419 WSW LOOP 323 STE 400, Tyler, TX 75701

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Other Names 1

Doing Business AsIntegrative Health Matters

Other Identifiers 1

Other1801905674TX · Dr. Danielson's Npi Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2174553

Integrative Health Matters · Tyler, TX

Active · expires Nov 4, 2027

CLIA Number45D2174553

Laboratory TypePhysician Office

Certificate Effective DateNovember 5, 2025

Certificate Expiration DateNovember 4, 2027

Laboratory DirectorAdrienne J. Carmack

Laboratory Phone(903) 595-8077

Laboratory LocationIntegrative Health Matters419 Wsw Loop 323, Suite 400, Tyler, TX 75701

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRADLEY FISHER FNP-C

Nurse Practitioner (Family)

419 WSW LOOP 323 STE 400
TYLER, TX 75701

Smith County (903) 595-8077

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Texas Functional Medicine Center, LLC's NPI number?

The NPI number for East Texas Functional Medicine Center, LLC is 1245847672. It was assigned to this organization in the NPPES registry on September 29, 2020. The provider is doing business as Integrative Health Matters.

Where is East Texas Functional Medicine Center, LLC located?

East Texas Functional Medicine Center, LLC is located at 419 Wsw Loop 323 Ste 400, Tyler, TX 75701. The listed phone number is (903) 595-8077.

What is East Texas Functional Medicine Center, LLC's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Public Health & General Preventive Medicine, with taxonomy code 2083P0901X.

Does East Texas Functional Medicine Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2174553) is associated with this NPI, valid through November 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does East Texas Functional Medicine Center, LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list East Texas Functional Medicine Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for East Texas Functional Medicine Center, LLC was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.