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General NPI Number Information
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NPI Number | 1396623708
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Entity Type | Organization
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Legal Business Name | NEUROBLOOM PLLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 4810 N COUNTY ROAD 2800
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City | LUBBOCK
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State | TX
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Zip | 79403-7297
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Country | US
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Telephone | 806-223-0016
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Fax | 806-230-1604
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Provider Business Mailing Address
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Address Line | 4810 N COUNTY ROAD 2800
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City | LUBBOCK
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State | TX
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Zip | 79403-7297
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Country | US
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Telephone | 806-223-0016
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Fax | 806-230-1604
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Authorized Official
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Title or Position | OWNER, FAMILY NURSE PRACTITIONER
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Name | PATRICIA PEREZ
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Credential | MSN, APRN, FNP-BC
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Telephone | 806-223-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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