ROCKDALE BLACKHAWK, LLC (NPI# 1982894408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982894408 |
| Entity Type | Organization |
| Organization Name | ROCKDALE BLACKHAWK, LLC |
| Other Organization Name | LITTLE RIVER MEDICAL CLINIC - HEARNE |
| Practice Address |
104 S Magnolia St Hearne TX 77859-2565 |
| Mailing Address |
Po Box 1010 Rockdale TX 76567-1010 |
| Practice Telephone | 9792800022 |
| Practice Fax Number | 9792800023 |
| Mailing Telephone | 5124464500 |
| Mailing Fax Number | 5124462063 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | SHANA DAVENPORT (INSURANCE CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 5124464500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Little River Medical Clinic - Hearne | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1760926604 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 623 Hwy 71 W, Suite 204, Bastrop, TX 78602-4166 | 2016-12-12 |
| 1124562053 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 815 Hwy 71 W, Suite 1150, Bastrop, TX 78602-0319 | 2016-12-12 |
| 1437693363 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 2500 West William Cannon Drive, Suite 401, Austin, TX 78745-5290 | 2016-12-12 |
| 1407399884 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 207 W Avenue E, Suite 1000, Lampasas, TX 76550-1820 | 2016-12-02 |
| 1285911123 | Rockdale Blackhawk, LLC | Clinic/Center | 1700 Brazos, Suite A, B and C, Rockdale, TX 76567 | 2011-11-07 |
| 1972047801 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 135 Bunton Creek Road, Suite 302a, Kyle, TX 78640-5701 | 2016-12-12 |
| 1538610274 | Rockdale Blackhawk, LLC | General Practice | 2200 Park Bend Dr, Bldg 2-301, Austin, TX 78758-5387 | 2016-10-18 |
| 1437448156 | Rockdale Blackhawk, LLC | Physiological Laboratory | 2401 Fm 646 Rd W, Suite B, Dickinson, TX 77539-3249 | 2011-04-04 |
| 1811100076 | Rockdale Blackhawk, LLC | General Acute Care Hospital | 1700 Brazos Ave, Rockdale, TX 76567-2517 | 2007-05-07 |
| Street Address |
104 S MAGNOLIA ST |
| City | HEARNE |
| State | TX |
| Zip Code | 77859-2565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609092980 | Steven Marc Catalina | Chiropractor | 104 S Magnolia St, Hearne, TX 77859-2565 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264909 | Vs Servant Hearts Home Care Service LLC | Hospice Care, Community Based | 114 S Magnolia St, Hearne, TX 77859 | 2020-08-10 |
| 1003373838 | Donna Ohde | Nurse Practitioner | 709 Barton St, Hearne, TX 77859 | 2019-02-28 |
| 1033751193 | Dianne Gradington | Counselor | 1306 Crennan Ln, Hearne, TX 77859-2034 | 2019-10-10 |
| 1194296236 | Shirilyn Monique Dykes | Specialist | 2063 Crennan Ln Ste C, Hearne, TX 77859-2094 | 2018-12-16 |
| 1154617124 | Jessica Marian Jentsch | Physical Therapy Assistant | 105 W 3rd St, Hearne, TX 77859-2501 | 2011-06-28 |
| 1285969550 | Christopher Ronald Peoples | Pharmacist | 118 W 4th St, Hearne, TX 77859-2506 | 2009-10-05 |
| 1114932738 | Laa Drug LLC | Pharmacy | 118 W 4th St, Hearne, TX 77859-2506 | 2006-07-30 |
| 1699339218 | Hearne Family Dentistry | Dentist | 202 W 4th St, Hearne, TX 77859-2508 | 2019-04-29 |
| 1861653396 | Renal Treatment Centers Southeast Lp | Clinic/Center | 106 Cedar St, Hearne, TX 77859-2523 | 2008-06-18 |
| 1962501288 | Brookshire Brothers Inc | Pharmacy | 400 W 2nd St, Hearne, TX 77859-2566 | 2006-09-22 |
| Find all providers in zip 77859 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1659987022 | Specialists In Geriatric and Palliative Care Medicine Pllc | Clinic/Center | 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 | 2020-09-21 |
| 1518573443 | Elizabeth Danielle Benavides | Clinic/Center | 1424 Tanager Ct, San Antonio, TX 78260-2455 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.