MEDICARE: CHRISTOPHER A. BLOOM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	017535	LA
2	207R00000X	Internal Medicine Physician	M5060	TX

General Provider Information

NPI Number	:	1518967686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER A. BLOOM MD

Provider Business Mailing Address
First Line	:	9888 FERGUSON RD STE 101B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3841
Country	:	US
Telephone Number	:	214-328-4389
Fax Number	:	214-328-4085

Provider Business Practice Location Address
First Line	:	9888 FERGUSON RD STE 101B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3841
Country	:	US
Telephone Number	:	214-328-4389
Fax Number	:	214-328-4085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	04/11/2025

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