Provider Demographics
NPI:1871864512
Name:ROCK SURGICAL GROUP PA
Entity Type:Organization
Organization Name:ROCK SURGICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAUNIKITIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-601-4263
Mailing Address - Street 1:10847 KUYKENDAHL RD
Mailing Address - Street 2:STE 350
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2777
Mailing Address - Country:US
Mailing Address - Phone:281-601-4263
Mailing Address - Fax:800-866-3074
Practice Address - Street 1:10847 KUYKENDAHL RD
Practice Address - Street 2:STE 350
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2777
Practice Address - Country:US
Practice Address - Phone:281-601-4263
Practice Address - Fax:800-866-3074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8778207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R9284OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8R9284OtherBLUE CROSS BLUE SHIELD OF TEXAS