| C A Bloom Md Pllc | |
|
1151 N Buckner Blvd Suite 407 Dallas TX 75218-3426 | |
| (214) 206-1445 | |
| (972) 908-2844 |
| Full Name | C A Bloom Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1151 N Buckner Blvd, Dallas, Texas |
| Authorized Official Name and Position | Christopher A Bloom (PHYSICIAN OWNER) |
| Authorized Official Contact | 2142061445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C A Bloom Md Pllc Po Box 251166 Plano TX 75025-1166 Ph: (214) 206-1445 | C A Bloom Md Pllc 1151 N Buckner Blvd Suite 407 Dallas TX 75218-3426 Ph: (214) 206-1445 |
| NPI Number | 1346395233 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 07/27/2021 |
| Medicare PECOS PAC ID | 3375649114 |
|---|---|
| Medicare Enrollment ID | O20070510000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346395233 | NPI | - | NPPES |
| 0011PG | Other | TX | BLUE SHIELD |
| 186021502 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M5060 (Texas) | Primary |
| Provider Name | Christopher A Bloom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518967686 PECOS PAC ID: 8527081462 Enrollment ID: I20060106000335 |
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