Bloom Therapy Etx, LLC

Organization Active NPI Speech-Language Pathologist · Huntington, TX

NPI 1821964537 · NPPES record last updated Oct 11, 2025

Key facts

NPI
1821964537
Entity type
Organization (NPI type 2)
Primary specialty
Speech-Language Pathologist 235Z00000X
Legal business name
BLOOM THERAPY ETX, LLC
Practice address
3226 Gilliland Creek Rd
Huntington, TX 75949-3436
Phone
(936) 465-8164
NPI assigned
Oct 11, 2025
Organization subpart
No

Authorized official

Name
Aley Vardeman, SLP
Title
Owner/Treating Therapist
Phone
(936) 465-8164

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20251205004370 TX Part B Supplier - Clinic/Group Practice 2961995063 Receives reassigned benefits from 1 practitioner
Practice locations: Lufkin, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X Yes

Addresses

Primary practice location

3226 Gilliland Creek Rd
Huntington, TX 75949-3436

Mailing address

3226 Gilliland Creek Rd
Huntington, TX 75949-3436
Phone (936) 465-8164

Other providers in Huntington, TX

All providers in Huntington, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.