Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mysti Blu Management Group, LLC

Organization Family Medicine Physician · NPI 1003632522

Mysti Blu Management Group, LLC is a Family Medicine Physician in Carrollton, Texas. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2459 E Hebron Pkwy Ste 130
Carrollton, TX 75010-4477
Phone: (972) 522-9799
Fax: (469) 546-9723
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Home Infusion Agency (primary) Taxonomy 251F00000X
Family Medicine Physician Taxonomy 207Q00000X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1003632522
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerria Bernestine — Owner · (310) 756-4829
NPI enumeratedNovember 30, 2024
Last updated in NPPESNovember 30, 2024
Certification dateNovember 30, 2024
Mailing address2459 E Hebron Pkwy Ste 130, Carrollton, TX 75010-4477

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