Healthcare Provider Details

I. General information

NPI: 1265342802
Provider Name (Legal Business Name): ANCHOR FUNCTIONAL MEDICINE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 W WALNUT HILL LN # 102
IRVING TX
75038-3270
US

IV. Provider business mailing address

1329 W WALNUT HILL LN # 102
IRVING TX
75038-3270
US

V. Phone/Fax

Practice location:
  • Phone: 940-843-1544
  • Fax: 972-535-0441
Mailing address:
  • Phone: 940-843-1544
  • Fax: 972-535-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIN BYBEE
Title or Position: CREDENTIALER AND RECOVERY BILLER
Credential:
Phone: 940-843-1544