Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bloom Integrative Wellness Center of South Lake, LLC

Organization Ambulatory Family Planning Facility · NPI 1033831227

Bloom Integrative Wellness Center of South Lake, LLC is an Ambulatory Family Planning Facility in Dallas, Texas. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

14114 Dallas Pkwy Ste 310
Dallas, TX 75254-1315
Phone: (844) 864-8928
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X
Ambulatory Family Planning Facility Taxonomy 261QA0005X

Record details

NPI number1033831227
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tiffany Reynolds — Ceo · (931) 980-1911
Other names Bloom Integrative Wellness Center
NPI enumeratedSeptember 14, 2022
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026
Mailing address539 W Commerce St # 4488, Dallas, TX 75208-1953

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