Organization
C A BLOOM MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER A BLOOM MD (PHYSICIAN OWNER)
(214) 206-1445
Entity
Organization
Contact information
Practice address
1151 N BUCKNER BLVD, SUITE 407, DALLAS, TX 75218-3426
(214) 206-1445
(972) 908-2844
Mailing address
PO BOX 251166, PLANO, TX 75025-1166
(214) 206-1445
(972) 908-2844
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011PG
BLUE SHIELD
TX
05
—
186021502
—
TX
Enumeration date
01/24/2007
Last updated
07/27/2021
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