# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Women's Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184963613
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 604 N ACADIA RD, STE 500, THIBODAUX, LA 70301-4743
- **Practice address phone:** (985) 448-1216
- **Practice address fax:** (985) 446-8765
- **Mailing address:** PO BOX 5478, THIBODAUX, LA 70302-5478
- **Mailing address phone:** (985) 448-1216
- **Mailing address fax:** (985) 446-8765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 207VX0000X | Obstetrics Physician | — | NULL | — |
| 207VX0000X | Obstetrics Physician | — | — | — |

## Other

- **Enumeration date:** 02/04/2013
- **Last updated:** 06/02/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2324845 | — | LA |