Bloom Primary Tx, PLLC
Bloom Primary Tx, PLLC provides Family Medicine Physician services in Southlake, Texas. Licensed in Texas. Registered with an NPI since 2015.
- Licensed in
- TX
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
545 S Nolen DrSouthlake, TX 76092-9176
Phone: (303) 993-1330
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence P2012 (TX) |
|---|---|
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 617313 (TX) |
Record details
| NPI number | 1275901340 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Debra Moon Wadelton — Authorized Official · (720) 923-1250 |
| NPI enumerated | September 8, 2015 |
| Last updated in NPPES | September 21, 2026 |
| Certification date | September 21, 2026 |
| Mailing address | 12600 W Colfax Ave Ste B200, Lakewood, CO 80215-3736 |
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