Organization
BASTROP BLACKHAWK LLC
Active
Other names
Lakeside Hospital at Bastrop
Organization subpart
No
Provider details
NPI number
Authorized official
TODD F BIEDERMAN (DIRECTOR/OFFICER)
(512) 681-3440
Entity
Organization
Contact information
Practice address
3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
(512) 321-8200
Mailing address
3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
(512) 321-8200
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
008314
TX
Other
Enumeration date
07/08/2009
Last updated
11/23/2009
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