Organization
ROBERT F. BLOOM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT FRANKLIN BLOOM MD, PA (DERMATOLOGIST)
(806) 797-6631
Entity
Organization
Contact information
Practice address
3413 20TH ST, LUBBOCK, TX 79410-1205
(806) 797-6631
(806) 797-6748
Mailing address
3413 20TH ST, LUBBOCK, TX 79410-1205
(806) 797-6631
(806) 797-6748
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
F0391
TX
207ND0101X
MOHS-Micrographic Surgery Physician
F0391
TX
207NS0135X
Procedural Dermatology Physician
F0391
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00FC57
MEDICARE ID
TX
Enumeration date
07/17/2007
Last updated
09/04/2007
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