| Bloom Medical Care, Llc | |
|
340 N Sam Houston Pkwy E Ste 205 Houston TX 77060-3394 | |
| (512) 999-2453 | |
| Not Available |
| Full Name | Bloom Medical Care, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 340 N Sam Houston Pkwy E Ste 205, Houston, Texas |
| Authorized Official Name and Position | Abimbola T Ayorinde (FOUNDER/CEO) |
| Authorized Official Contact | 5129992453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Medical Care, Llc 340 N Sam Houston Pkwy E Ste 205 Houston TX 77060-3394 Ph: (210) 992-2654 | Bloom Medical Care, Llc 340 N Sam Houston Pkwy E Ste 205 Houston TX 77060-3394 Ph: (512) 999-2453 |
| NPI Number | 1497451884 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 02/08/2023 |
| Medicare PECOS PAC ID | 0840653671 |
|---|---|
| Medicare Enrollment ID | O20230828001549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497451884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Germaine N Tezano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396114708 PECOS PAC ID: 4789985763 Enrollment ID: I20151216001325 |
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