MEDICARE: BLOOMING ROSE HEALTH GROUP, PLLC

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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1790618213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMING ROSE HEALTH GROUP, PLLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR # 31672
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	214-444-6259
Fax Number	:

Provider Business Practice Location Address
First Line	:	110B ROUNDABOUT DR STE 8
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-1990
Country	:	US
Telephone Number	:	214-444-3259
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELLEY MONROE
Credential	:	APRN, PMHNP-BC
Telephone Number	:	817-344-0004

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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