Blue Star Dermatology & Aesthetics Management LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BLUE STAR DERMATOLOGY & AESTHETICS MANAGEMENT LLC

Practice address

3800 Gaylord Pkwy Ste 1080
Frisco, TX 75034-9416

Phone

(972) 497-4153

NPI assigned

May 25, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Reid Thomas McSwiggan, NONE

Title

Office Manager

Phone

(972) 497-4153

Specialties & licenses 1

Addresses

Other names 1

• Blue Star Dermatology & Aesthetics Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1124710363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COWBOYS WAY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341977",
            "telephone_number": "972-497-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 GAYLORD PKWY STE 1080",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349416",
            "telephone_number": "972-497-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STAR DERMATOLOGY & AESTHETICS MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "MCSWIGGAN",
        "authorized_official_first_name": "REID",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-497-4153",
        "authorized_official_credential": "NONE"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Star Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Star Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Diane Bloom, MS, RD, LD, CEDRD
• Bloomfield Medical Clinic
• Blossoming Brains PLLC
• Blue Medical Solutions LLC
• Blue RX
• Blue Star Smiles PLLC
• Blue Stone Frisco JV, LLP
• Blue Stone Frisco JV, LLP
• Blue Stone Frisco JV, LLP Dba Blue Star Imaging at the Star
• Blue Zone Medical Group PLLC

• Dermatology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.