Organization
ROCKDALE BLACKHAWK LLC
Active
Other names
Richards Memorial Imaging Fairmont
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN OWENS (OWNER)
(512) 445-4502
Entity
Organization
Contact information
Practice address
3692 E SAM HOUSTON PKWY S, PASADENA, TX 77505-3137
(512) 450-4502
Mailing address
3692 E SAM HOUSTON PKWY S, PASADENA, TX 77505-3137
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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