Organization
ROCKDALE BLACKHAWK, LLC
Active
Other names
Little River Healthcare Southwest Orthopedic Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF MADISON (CEO)
(512) 481-7060
Entity
Organization
Contact information
Practice address
135 BUNTON CREEK ROAD, SUITE 302A, KYLE, TX 78640-5701
(512) 451-1969
Mailing address
1 CHISHOLM TRAIL, SUITE 400, ROUND ROCK, TX 78681-5094
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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