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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLOOM PRIMARY TX, PLLC
NPI 1275901340
Family Medicine in Southlake, TX

Active since September 08, 2015
545 S NOLEN DR, SOUTHLAKE, TX 76092(303) 993-1330 Get Directions Write a Review

NPPES record last updated: September 21, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Bloom Primary Tx, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOM PRIMARY TX, PLLC (NPI 1275901340) is a healthcare organization registered as a family medicine in Southlake, Texas and active in the NPI registry since September 2015. The organization lists Debra Kay Moon Wadelton, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1275901340
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBLOOM PRIMARY TX, PLLC
Location Address545 S NOLEN DRSouthlake, TX 76092-9176
Mailing Address12600 W Colfax Ave Ste B200Lakewood, CO 80215-3736 · (303) 993-1330 · Fax (303) 284-4082
Phone(303) 993-1330
Organization SubpartNo
Authorized OfficialDebra Kay Moon WadeltonAuthorized Official · (720) 923-1250
Enumeration DateSeptember 8, 2015
Last NPPES UpdateSeptember 21, 2026
NPPES CertifiedSeptember 21, 2026
✔ NPI 1275901340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · P2012
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 617313 (TX)
545 S NOLEN DR, Southlake, TX 76092
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloom Primary Tx, PLLC's NPI number?

The NPI number for Bloom Primary Tx, PLLC is 1275901340. It was assigned to this organization in the NPPES registry on September 8, 2015.

Where is Bloom Primary Tx, PLLC located?

Bloom Primary Tx, PLLC is located at 545 S Nolen Dr, Southlake, TX 76092. The listed phone number is (303) 993-1330.

What is Bloom Primary Tx, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Bloom Primary Tx, PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Bloom Primary Tx, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bloom Primary Tx, PLLC was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.