Organization
BLOOM PHYSICIAN HOUSECALLS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA MOON WADELTON (AUTHORIZED OFFICIAL)
(720) 923-1250
Entity
Organization
Contact information
Practice address
8000 W IH 10 STE 201, SAN ANTONIO, TX 78230-3879
(303) 993-1330
Mailing address
PO BOX 17112, DENVER, CO 80217-0112
(720) 923-1250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/05/2026
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