Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

BLOOM PRIMARY TX II, PA
NPI 1689598377
Internal Medicine in Southlake, TX

Q: What is Bloom Primary Tx II, PA's NPI number?

The NPI number for Bloom Primary Tx II, PA is 1689598377. It was assigned to this organization in the NPPES registry on August 6, 2026.

Q: What is Bloom Primary Tx II, PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since August 06, 2026

545 S NOLEN DR STE 300, SOUTHLAKE, TX 76092(303) 993-1330 Get Directions Write a Review

NPPES record added: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Bloom Primary Tx Ii, Pa NPPES

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

BLOOM PRIMARY TX II, PA (NPI 1689598377) is a healthcare organization registered as an internal medicine in Southlake, Texas and active in the NPI registry since August 2026. The organization lists Debra Moon Wadelton, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1689598377

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameBLOOM PRIMARY TX II, PA

Location Address545 S NOLEN DR STE 300Southlake, TX 76092-9176

Mailing Address12600 W Colfax Ave Ste 200Lakewood, CO 80215-3733 · (303) 993-1330

Phone(303) 993-1330

Organization SubpartNo

Authorized OfficialDebra Moon WadeltonAuthorized Official · (720) 923-1250

Enumeration DateAugust 6, 2026

NPPES CertifiedAugust 6, 2026

✔ NPI 1689598377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

545 S NOLEN DR STE 300, Southlake, TX 76092

Open in Google Maps ↗

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

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 II, PA's NPI number?

The NPI number for Bloom Primary Tx II, PA is 1689598377. It was assigned to this organization in the NPPES registry on August 6, 2026.

Where is Bloom Primary Tx II, PA located?

Bloom Primary Tx II, PA is located at 545 S Nolen Dr Ste 300, Southlake, TX 76092. The listed phone number is (303) 993-1330.

What is Bloom Primary Tx II, PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Bloom Primary Tx II, PA was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.