| NPI | 1164621215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FRANKLIN BLOOM Dermatologist 806-797-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX F0391) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX F0391) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX F0391) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-09-04 |