OrganizationActive
Mysti Blu Management Group, LLC
NPI 1003632522 · Home Infusion Agency · Carrollton, TX
Provider details
- NPI number
- 1003632522
- Entity type
- Organization
- Primary specialty
- Home Infusion AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jerria Bernestine, Owner(310) 756-4829
Specialties & taxonomies
Agencies
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Infusion Therapy Clinic/Center261QI0500X
Ambulatory Health Care Facilities
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2459 E Hebron Pkwy Ste 130
Carrollton, TX 75010-4477
Phone: (972) 522-9799
Fax: (469) 546-9723
Approximate (ZIP-level) locationGet directions
Mailing address
2459 E Hebron Pkwy Ste 130
Carrollton, TX 75010-4477
Registry dates
- Enumerated
- 2024-11-30
- Last updated
- 2024-11-30
- Certified
- 2024-11-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.