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General NPI Number Information
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NPI Number | 1497451884
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Entity Type | Organization
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Legal Business Name | BLOOM MEDICAL CARE, LLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 10107 LOUETTA RD STE 105
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City | HOUSTON
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State | TX
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Zip | 77070-1574
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Country | US
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Telephone | 210-992-2654
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Fax |
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Provider Business Mailing Address
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Address Line | 10107 LOUETTA RD STE 105
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City | HOUSTON
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State | TX
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Zip | 77070-1574
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Country | US
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Telephone | 210-992-2654
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | ABIMBOLA T AYORINDE
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Credential |
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Telephone | 512-999-2453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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