Individual
MANUEL G BLOOM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6550 FANNIN ST STE 1101, HOUSTON, TX 77030-2740
(713) 441-3948
(713) 441-1224
Mailing address
6445 MAIN ST FL 22, HOUSTON, TX 77030-1502
(713) 441-7182
(713) 796-1701
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
E7566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121724203
GROUP MEDICAID TPI
TX
05
—
136820102
—
TX
Enumeration date
08/11/2006
Last updated
07/07/2023
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