# BASTROP BLACKHAWK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeside Hospital at Bastrop
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881823151
- **Authorized official:** TODD F BIEDERMAN (DIRECTOR/OFFICER)
- **Authorized official phone:** (512) 681-3440

## Contact information

- **Practice address:** 3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
- **Practice address phone:** (512) 321-8200
- **Mailing address:** 3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
- **Mailing address phone:** (512) 321-8200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 282N00000X | General Acute Care Hospital | 008314 | TX | Yes |

## Other

- **Enumeration date:** 07/08/2009
- **Last updated:** 11/23/2009