MYSTI BLU LLC NPI 1609550219

NPI Information

NPI: 1609550219
Provider Name: MYSTI BLU LLC
Classification: Clinic/Center - 261QI0500X
Entity Type: Organization

Specialization: Infusion Therapy

Address:
2459 E. HEBRON PARKWAY
#130
CARROLLTON, TX
ZIP 75010
Phone: (972) 522-9799
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MYSTI BLU LLC is an infusion therapy clinic center in Carrollton, TX. MYSTI BLU LLC NPI is 1609550219. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2459 E. HEBRON PARKWAY
#130
CARROLLTON, TX
ZIP 75010
Phone: (972) 522-9799
Fax: (469) 546-9723

The provider's authorized official is Jerria Bernestine .
The authorized official title is Owner and has the following contact phone number (972) 522-9799.

The enumeration date for this NPI number is 6/14/2023 and was last updated on 1/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207QG0300X	Family Medicine	Geriatric Medicine	No
2	251F00000X	Home Infusion		No
3	207Q00000X	Family Medicine		No
4	261QI0500X	Clinic/Center	Infusion Therapy	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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