DR. DOUGLAS RANDAL BLOOM PHD
NPI 1417001116
Clinical Neuropsychologist in Houston, TX

Q: What is Douglas Bloom's NPI number?

The NPI number for Douglas Bloom is 1417001116. It was assigned to this individual provider in the NPPES registry on January 22, 2007.

Q: What is Douglas Bloom's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Douglas Bloom was last updated on January 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since January 22, 2007

6621 FANNIN ST, CCC 1630.00, HOUSTON, TX 77030(832) 822-3700(832) 825-4164 Get Directions Write a Review

NPPES record last updated: January 10, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Douglas Randal Bloom Phd NPPES

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

DR. DOUGLAS RANDAL BLOOM PHD (NPI 1417001116) is an individual clinical neuropsychologist in Houston, Texas, licensed in Texas (25782) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1417001116

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. DOUGLAS RANDAL BLOOMCredential: PHD

Location Address6621 FANNIN ST, CCC 1630.00Houston, TX 77030-2303

Mailing Address6621 Fannin St, Ccc 1630.00Houston, TX 77030-2303 · (832) 822-3700 · Fax (832) 825-4164

Phone(832) 822-3700

Fax(832) 825-4164

Sole ProprietorNo

Enumeration DateJanuary 22, 2007

Last NPPES UpdateJanuary 10, 2023

NPPES CertifiedJanuary 10, 2023

✔ NPI 1417001116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in TX · 25782

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologistTaxonomy 103T00000X · License 25782 (TX)

6621 FANNIN ST, Houston, TX 77030

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Other Identifiers 1

Medicaid1027542-03TX

Other Providers at the Same Location NPPES 20

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