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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