MEDICARE: BARE ROOTS WELLNESS, 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	163WP0808X	Psychiatric/Mental Health Registered Nurse

General Provider Information

NPI Number	:	1851158489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARE ROOTS WELLNESS, LLC

Provider Business Mailing Address
First Line	:	13101 PRESTON RD STE 210-282
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-5237
Country	:	US
Telephone Number	:	214-560-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	13101 PRESTON RD STE 110-282
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-5237
Country	:	US
Telephone Number	:	214-560-4222
Fax Number	:

Authorized Official
Title or Position	:	RN
Name	:	CRYSTAL BROWN
Credential	:	RN
Telephone Number	:	214-560-4222

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	03/06/2024

Similar Medicare Providers

1285295410 — LIVE OAK ANESTHESIA, PLLC
Practice Location Address:

13101 PRESTON RD # 110648
DALLAS, TX
75240-5237

Practice Phone: 512-422-0633
Practice Fax:

1871726141 — DR. EMILY REISS BISIGNANO
Practice Location Address:

13101 PRESTON RD , SUITE 504
DALLAS, TX
75240-5237

Practice Phone: 469-248-5445
Practice Fax:

1992258552 — REISS PSYCHOLOGY SERVICES
Practice Location Address:

13101 PRESTON RD
DALLAS, TX
75240-5237

Practice Phone: 469-247-5445
Practice Fax:

1235825373 — TRANISHA DEANN JOHNSON
Practice Location Address:

13101 PRESTON RD STE 110-5021
DALLAS, TX
75240-5237

Practice Phone: 682-377-2547
Practice Fax:

1669239281 — CRYSTAL Q BROWN RN
Practice Location Address:

13101 PRESTON RD STE 110-282
DALLAS, TX
75240-5237

Practice Phone: 214-263-6992
Practice Fax:

1699014274 — MRS. LEAH HOWARD EUSTACE M.A. CCC-SLP
Practice Location Address:

4607 TIMBERGLEN RD , APT 313
DALLAS, TX
75287-5237

Practice Phone: 631-721-7274
Practice Fax: 631-841-8879

Directions to “BARE ROOTS WELLNESS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.