Organization
ROCKDALE BLACKHAWK LLC
Active
Other names
Little River Healthcare Bastrop Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY P MADISON (OWNER)
(512) 446-4500
Entity
Organization
Contact information
Practice address
3101 HIGHWAY 71 E, SUITE 108, BASTROP, TX 78602-5156
(512) 332-0222
Mailing address
3101 HIGHWAY 71 E, SUITE 108, BASTROP, TX 78602-5156
(512) 332-0222
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2011
Last updated
05/14/2015
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