Organization
BLOOM PHYSICIAN HOUSECALLS, PA
Active
Organization
BLOOM PHYSICIAN HOUSECALLS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KAY MOON WADELTON (BILLING AND CREDENTIALING MANAGER)
(720) 923-1250
Entity
Organization
Contact information
Practice address
8000 W IH 10 STE 240, SAN ANTONIO, TX 78230-3868
(720) 923-1250
Mailing address
12600 W COLFAX AVE STE B200, LAKEWOOD, CO 80215-3736
(720) 923-1250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
12/18/2024
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