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Organization
ROBERT A BLOOM MD PLLC
Active
Organization
ROBERT A BLOOM MD PLLC
Active
Other names
Robert A Bloom MD
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A BLOOM MD (DOCTOR)
(817) 338-4636
Entity
Organization
Contact information
Practice address
416 S. HENDERSON ST., FORT WORTH, TX 76104
(817) 338-4636
(817) 335-5421
Mailing address
416 S. HENDERSON ST., FORT WORTH, TX 76104
(817) 338-4636
(817) 335-5421
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184011801
—
TX
Enumeration date
03/09/2015
Last updated
03/31/2015
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