Individual
TYLER LEE BLOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 W TERRELL AVE STE 500, FORT WORTH, TX 76104-2810
(817) 252-5000
(817) 252-5016
Mailing address
1300 W TERRELL AVE STE 500, FORT WORTH, TX 76104-2810
(817) 252-5000
(817) 252-5016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
52345
TN
207RC0000X
Cardiovascular Disease Physician
R9719
TX
207RI0011X
Interventional Cardiology Physician
Primary
R9719
TX
Other
Enumeration date
04/23/2012
Last updated
06/25/2019
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