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Organization
BLACKHAWK PHYSICIAN GROUP
Active
Organization
BLACKHAWK PHYSICIAN GROUP
Active
Parent organization
BLACKHAWK HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLACKHAWK HEALTHCARE, LLC
Authorized official
TODD BIEDERMAN (PRESIDENT/CEO)
(512) 681-3440
Entity
Organization
Contact information
Practice address
1700 BRAZOS AVE, ROCKDALE, TX 76567-2517
(512) 446-4502
Mailing address
6500 RIVER PLACE BLVD, BUILDING 1, SUITE 350, AUSTIN, TX 78730-1119
(512) 681-3440
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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