Bloom Integrative Wellness Center Of South Lake, Llc

Specialty details in registry · Dallas, TX

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At a glance

14114 Dallas Pkwy Ste 310, Dallas, TX 75254-1315

NPPES record updated Jan 27, 2026. Public records can lag behind changes at a practice.

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Practice location

14114 Dallas Pkwy Ste 310
Dallas, TX 75254-1315

Professional details: NPI, taxonomy & registry record

NPI1033831227

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 363LW0102X
Enumeration date: Sep 14, 2022
Record updated: Jan 27, 2026

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

261QA0005X

Specialty details in registry

363LW0102X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

14114 Dallas Pkwy Ste 310
Dallas, TX 75254-1315

Phone: (844) 864-8928

Mailing address

539 W COMMERCE ST # 4488

DALLAS, TX 752081953

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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