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Manuel G Bloom

Internal Medicine

Allopathic & Osteopathic Physicians

6550 Fannin St Ste 1101, Houston, TX 77030-2740

PECOS Enrollment

This provider is enrolled in PECOS as MANUEL BLOOM.

Based on the most recent information from CMS, provider Manuel G Bloom is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 8:41 AM.

Profile Details

Provider ID
1023029089
Provider Type
Individual
Full Name
Bloom, Manuel G
Credential
M.D

Gender
Male
Sole Proprietor
No
Enumeration Date
8/11/2006
Last Updated
7/7/2023

Contact Information

Practice Location

6550 Fannin St Ste 1101, Houston, TX 77030-2740

(713) 441-3948

(713) 441-1224

Mailing Location

6445 Main St Fl 22, Houston, TX 77030-1502

(713) 441-7182

(713) 796-1701

Provider Taxonomies

Code	Description	License
Code 207RP1001X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License E7566 Texas

Provider Identifiers

ID	Description	Issuer
ID 121724203	Description Other	Issuer GROUP MEDICAID TPI Texas
ID 136820102	Description Medicaid	Issuer Unlisted Texas

Manuel G Bloom

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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