ROCKDALE BLACKHAWK LLC NPI 1982894408

NPI Information

  • NPI: 1982894408
  • Provider Name: ROCKDALE BLACKHAWK, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: LITTLE RIVER MEDICAL CLINIC - HEARNE
  • Address: 104 S MAGNOLIA ST
    HEARNE, TX
    ZIP 77859
  • Phone: (979) 280-0022

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NPI Details

ROCKDALE BLACKHAWK, LLC is a primary care clinic center in Hearne, TX. ROCKDALE BLACKHAWK, LLC NPI is 1982894408. The provider is registered as an organization entity type.
The provider Is Doing Business As Little River Medical Clinic - Hearne.

The provider's business location address is:

104 S MAGNOLIA ST
HEARNE, TX
ZIP 77859-565
Phone: (979) 280-0022
Fax: (979) 280-0023

The provider's authorized official is Shana Davenport .
The authorized official title is Insurance Credentialing Supervisor and has the following contact phone number (512) 446-4500.

The enumeration date for this NPI number is 7/31/2007 and was last updated on 2/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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