Deactivated NPI 1548363971 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Franklin Bloom , MD

Dermatology • Lubbock, TX

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Bloom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 07, 2006

NPI Deactivation Date June 18, 2021

Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Bloom, MD was a registered Dermatology practicing in Lubbock, TX. Throughout an active medical career spanning 15 years, Dr. Bloom provided care at the practice location at 3413 20TH ST until profile deactivation on 2021-06-18.

Historical Medicare Part B clinical services included pathology examination of tissue using a microscope, intermediate complexity, pathology examination of specimen during surgery, first tissue block, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3413 20th St

Lubbock, TX 79410

Telephone 8067976631

Fax 8067976748

Associated Practice Facility / Clinic

🏢 Robert F. Bloom, Md, Pa Facility NPI 1164621215

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Lubbock, TX

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 24.2 Yrs

State Avg: 20.2 Yrs

Regional Practice Density

14 Specialists

Practicing in Lubbock, TX (1210 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

53.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	282	135	$165.76	$70.22
88331 Pathology examination of specimen during surgery, first tissue block	243	135	$197.78	$102.89
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	229	159	$62.63	$55.30
17003 Destruction of precancer skin growth, 2-14 growths	215	50	$25.00	$6.47
17315 Removal and microscopic exam of growth, each additional block after 5 tissue blocks	204	50	$153.00	$76.59
17000 Destruction of skin growth	98	85	$115.00	$54.00
99213 Established patient office or other outpatient visit, typically 15 minutes	87	73	$120.00	$89.89
11441 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth	76	60	$320.16	$144.80
17004 Destruction of precancer skin growth, 15 or more growths	69	58	$258.39	$163.78
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	51	41	$650.00	$407.46
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	51	47	$1262.20	$571.79
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$107.83	$71.48
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	39	31	$283.36	$121.68
88332 Pathology examination of specimen during surgery, each additional tissue block	39	13	$87.22	$54.08
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	30	26	$315.02	$134.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$156.01	$110.10
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	27	26	$388.66	$188.54
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	26	19	$709.34	$389.89
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	26	23	$912.12	$247.72
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	24	23	$1179.04	$593.08
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	22	21	$815.78	$226.01
11421 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	16	15	$298.86	$129.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	969	410	$165.76	$68.81
17003 Destruction of precancer skin growth, 2-14 growths	877	215	$25.00	$5.90
88331 Pathology examination of specimen during surgery, first tissue block	850	411	$197.78	$96.81
99213 Established patient office or other outpatient visit, typically 15 minutes	789	458	$120.00	$73.28
17315 Removal and microscopic exam of growth, each additional block after 5 tissue blocks	752	162	$153.00	$76.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	441	313	$62.63	$44.22
17000 Destruction of skin growth	383	279	$115.00	$55.79
11441 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth	253	177	$320.16	$136.43
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	240	149	$650.00	$389.42
17004 Destruction of precancer skin growth, 15 or more growths	223	141	$258.39	$152.83
99202 New patient office or other outpatient visit, typically 20 minutes	221	221	$107.83	$73.88
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	216	164	$1262.20	$578.89
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	135	100	$283.36	$117.79
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	124	91	$315.02	$135.70
88332 Pathology examination of specimen during surgery, each additional tissue block	120	33	$87.22	$53.65
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	116	98	$912.12	$234.86
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	105	85	$1179.04	$604.50
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	94	63	$709.34	$373.58
99201 New patient office or other outpatient visit, typically 10 minutes	92	92	$63.07	$44.37
11421 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	83	67	$298.86	$118.36
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	80	68	$815.78	$216.84
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	77	65	$388.66	$173.54
11422 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	55	45	$334.64	$159.87
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	30	23	$256.10	$102.80
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	26	24	$366.02	$181.45
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	25	22	$274.29	$143.22
17110 Destruction of up to 14 skin growths	25	11	$175.00	$104.80
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	21	21	$732.05	$248.30
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	18	16	$256.58	$129.41
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	15	15	$1472.40	$980.31
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	13	$293.93	$170.11
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	12	11	$259.12	$171.77
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	12	11	$1369.34	$914.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,075	420	$25.00	$5.35
99213 Established patient office or other outpatient visit, typically 15 minutes	1,905	816	$120.00	$71.07
88305 Pathology examination of tissue using a microscope, intermediate complexity	1,095	517	$165.76	$66.10
88331 Pathology examination of specimen during surgery, first tissue block	986	519	$197.78	$93.61
17000 Destruction of skin growth	890	572	$115.00	$56.59
17315 Removal and microscopic exam of growth, each additional block after 5 tissue blocks	590	157	$153.00	$75.96
17004 Destruction of precancer skin growth, 15 or more growths	465	209	$258.39	$145.57
99202 New patient office or other outpatient visit, typically 20 minutes	411	411	$107.83	$72.97
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	349	277	$62.63	$43.23
11441 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth	349	234	$320.16	$137.31
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	305	201	$650.00	$378.18
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	298	222	$1262.20	$594.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	173	142	$189.00	$104.84
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	165	127	$912.12	$234.26
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	152	121	$283.36	$117.80
99201 New patient office or other outpatient visit, typically 10 minutes	122	122	$63.07	$43.93
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	117	102	$315.02	$138.34
88332 Pathology examination of specimen during surgery, each additional tissue block	107	31	$87.22	$50.93
11421 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	106	78	$296.04	$117.16
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	95	84	$1179.04	$586.30
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	83	72	$815.78	$207.90
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	81	71	$388.66	$168.77
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	79	63	$709.34	$356.58
11422 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	77	62	$334.64	$148.91
17110 Destruction of up to 14 skin growths	44	24	$175.00	$103.07
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	43	36	$256.10	$105.94
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	34	34	$732.05	$245.04
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	29	23	$256.58	$124.89
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	28	21	$274.29	$145.32
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	21	21	$366.02	$177.88
17273 Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals	21	18	$298.47	$167.58
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	21	20	$259.12	$165.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$156.01	$93.55
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	16	16	$1472.40	$975.09
17283 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm	14	13	$352.41	$194.64
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	13	13	$1369.34	$906.65
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	12	11	$568.06	$208.27

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,585	309	$25.00	$5.01
99213 Established patient office or other outpatient visit, typically 15 minutes	1,507	688	$120.00	$69.99
88305 Pathology examination of tissue using a microscope, intermediate complexity	1,108	518	$165.76	$65.54
88331 Pathology examination of specimen during surgery, first tissue block	1,096	517	$197.78	$93.72
17315 Removal and microscopic exam of growth, each additional block after 5 tissue blocks	696	168	$153.00	$77.02
17000 Destruction of skin growth	613	420	$115.00	$55.15
17004 Destruction of precancer skin growth, 15 or more growths	499	228	$258.39	$138.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	489	334	$62.91	$42.04
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	455	225	$650.00	$369.49
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	389	245	$1262.20	$561.02
11441 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth	356	217	$320.11	$127.63
99202 New patient office or other outpatient visit, typically 20 minutes	330	330	$107.83	$72.18
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	192	143	$912.12	$230.83
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	162	118	$283.36	$109.56
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	148	119	$388.66	$167.22
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	148	118	$316.94	$138.67
99201 New patient office or other outpatient visit, typically 10 minutes	142	142	$63.07	$42.71
11421 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	114	83	$298.86	$109.90
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	106	89	$1179.04	$590.10
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	97	86	$815.78	$206.21
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	96	73	$709.34	$355.57
11422 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	94	85	$334.64	$153.22
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	40	38	$732.05	$238.50
17110 Destruction of up to 14 skin growths	37	21	$175.00	$99.59
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	33	27	$256.10	$98.67
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	28	21	$1369.34	$892.50
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	25	23	$1472.40	$977.68
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	21	19	$1569.02	$1037.25
17273 Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals	20	18	$298.47	$169.71
17283 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm	20	15	$352.41	$169.69
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	18	18	$256.58	$127.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$156.01	$103.97
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	14	14	$259.12	$171.94
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	14	12	$274.29	$151.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$189.00	$104.22
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	12	11	$568.06	$189.77
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	11	11	$366.02	$185.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	1,353	555	$165.76	$64.26
99213 Established patient office or other outpatient visit, typically 15 minutes	1,345	617	$119.96	$69.44
88331 Pathology examination of specimen during surgery, first tissue block	1,281	558	$197.78	$91.65
17003 Destruction of precancer skin growth, 2-14 growths	1,204	215	$21.04	$5.27
17315 Removal and microscopic exam of growth, each additional block after 5 tissue blocks	747	144	$153.00	$76.15
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	592	276	$650.00	$366.52
17004 Destruction of precancer skin growth, 15 or more growths	499	241	$258.39	$142.30
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	422	277	$1262.20	$583.86
17000 Destruction of skin growth	394	290	$111.24	$51.79
99202 New patient office or other outpatient visit, typically 20 minutes	360	360	$107.85	$71.13
11441 Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth	340	227	$320.16	$126.57
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	233	164	$912.12	$224.58
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	229	165	$315.02	$122.61
11442 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	224	158	$388.66	$157.07
17314 Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks	182	110	$709.34	$353.15
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	154	113	$1179.04	$582.83
11422 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	133	98	$334.64	$136.20
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	127	98	$815.78	$205.94
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	121	93	$283.36	$107.80
11421 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	105	85	$298.86	$107.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	103	86	$63.51	$41.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	69	$188.60	$103.00
88332 Pathology examination of specimen during surgery, each additional tissue block	77	24	$87.22	$50.27
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	40	37	$732.05	$241.22
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	36	33	$256.10	$92.08
11403 Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm	31	30	$366.02	$161.72
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	28	23	$256.58	$126.94
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	26	22	$1472.40	$970.53
99201 New patient office or other outpatient visit, typically 10 minutes	23	23	$63.07	$41.71
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	23	23	$1569.02	$1030.58
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	23	19	$568.06	$204.04
17110 Destruction of up to 14 skin growths	22	11	$167.91	$104.47
13133 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less	21	19	$259.12	$171.04
11420 Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	19	17	$233.00	$82.50
11443 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm	14	14	$540.34	$213.19
17273 Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals	13	13	$298.47	$167.39
11400 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs	13	13	$229.08	$103.87
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	13	12	$274.29	$160.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$156.01	$97.70

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License TX F0391

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated June 18, 2021

Record deactivated on June 18, 2021

✅

NPI Profile Active February 13, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location February 13, 2013

Registered at 3413 20TH ST, LUBBOCK, TX 79410 (Tel: 8067976631)

📍

Updated Business Mailing Address February 13, 2013

Registered at 3413 20TH ST, LUBBOCK, TX 79410 (Tel: 8067976631)

👤

Provider Name / Credentials Updated February 13, 2013

Recorded as ROBERT BLOOM, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2013

Dermatology (License #F0391 in TX)

🟢

Initial NPI Registration & Enumeration September 07, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1548363971

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 07, 2006

Last Update: February 13, 2013

Deactivation Date: June 18, 2021

Update or Correct Profile

Mailing Address

3413 20th St

Lubbock, TX 79410

Phone: 8067976631

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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