| Mysti Blu LLC | |
|
2459 E. Hebron Parkway #130 Carrollton TX 75010 | |
| (972) 522-9799 | |
| (469) 546-9723 |
| Full Name | Mysti Blu LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 2459 E. Hebron Parkway, Carrollton, Texas |
| Authorized Official Name and Position | Jerria Bernestine (OWNER) |
| Authorized Official Contact | 9725229799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mysti Blu LLC 3333 Preston Road #300 Frisco TX 75034 Ph: (972) 522-9799 | Mysti Blu LLC 2459 E. Hebron Parkway #130 Carrollton TX 75010 Ph: (972) 522-9799 |
| NPI Number | 1609550219 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 03/17/2025 |
| Certification Date | 03/17/2025 |
| Medicare PECOS PAC ID | 5799137972 |
|---|---|
| Medicare Enrollment ID | O20240124000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609550219 | NPI | - | NPPES |
| Provider Name | Jerria M Bernestine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578024931 PECOS PAC ID: 3274966692 Enrollment ID: I20191125002534 |
Kenneth Baird, M.D., Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3012 E Hebron Pkwy, Ste 110, Carrollton, TX 75010 Phone: 214-263-3234 |
Care Express Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1902 Country Club Dr, Suite 160, Carrollton, TX 75006 Phone: 469-215-2555 Fax: 469-215-2553 |
Mysti Blu Management Group, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2459 E Hebron Pkwy Ste 130, Carrollton, TX 75010 Phone: 972-522-9799 Fax: 469-546-9723 |
Essencia Family Practice and Immediate Care Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1509 W Hebron Pkwy Ste 140, Carrollton, TX 75010 Phone: 972-306-0016 Fax: 972-306-0017 |
Kuraoka Clinic Texas, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3012 E Hebron Pkwy Ste 104, Carrollton, TX 75010 Phone: 972-306-0808 |
Mahmood B. Panjwani M.d, P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3740 N Josey Ln, Suite 206, Carrollton, TX 75007 Phone: 214-731-0031 Fax: 214-731-0065 |