Rockdale Blackhawk LLC

NPI #1831479682 in Georgetown, Texas

Provider Information

NPI Number: 1831479682
Entity Type: Organization
Organization Name: Rockdale Blackhawk LLC
Primary Specialty: Clinic/Center - Radiology
Enumeration Date: Aug 25, 2011
Last Updated: Sep 29, 2011

Practice Location

Address: 1528 LEANDER RD
City: Georgetown
State: Texas
ZIP Code: 78628-8801
Phone: (512) 863-0782

Authorized Official

Name: JEFFREY P MADISON
Title: CEO
Phone: (512) 446-4500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Radiology — Radiology	261QR0200X	Primary

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