Blackhawk Physician Group

NPI #1609021765 in Rockdale, Texas

Provider Information

NPI Number: 1609021765
Entity Type: Organization
Organization Name: Blackhawk Physician Group
Subpart: Yes (part of a larger organization)
Parent Organization: BLACKHAWK HEALTHCARE, LLC
Primary Specialty: General Practice
Enumeration Date: Nov 17, 2008
Last Updated: Nov 17, 2008

Practice Location

Address: 1700 BRAZOS AVE
City: Rockdale
State: Texas
ZIP Code: 76567-2517
Phone: (512) 446-4502

Authorized Official

Name: TODD BIEDERMAN
Title: PRESIDENT/CEO
Phone: (512) 681-3440

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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