MEDICARE: MY CARE BUDDY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251X00000X	Supports Brokerage Agency

General Provider Information

NPI Number	:	1043180300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY CARE BUDDY LLC

Provider Business Mailing Address
First Line	:	13675 NOEL RD APT 445
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 W MAIN ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1929
Country	:	US
Telephone Number	:	214-799-1444
Fax Number	:

Authorized Official
Title or Position	:	REP
Name	:	TKEYAH CELESTE RANDALL
Credential	:
Telephone Number	:	214-799-1444

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	12/18/2025

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Directions to “MY CARE BUDDY LLC ” Practice Location

Language	Start Address	Practice Location

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