MEDICARE: MRS. MYKESHA TOLBERT CST/CSFA

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	246ZC0007X	Surgical Assistant		TX

General Provider Information

NPI Number	:	1073449401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MYKESHA TOLBERT CST/CSFA

Provider Business Mailing Address
First Line	:	909 REGAL BLUFF LN
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-5565
Country	:	US
Telephone Number	:	469-846-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 US-287
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065
Country	:	US
Telephone Number	:	469-846-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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Directions to “ MRS. MYKESHA TOLBERT CST/CSFA” Practice Location

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