# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Endocrinology Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215355128
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 726 N ACADIA RD, STE 3300, THIBODAUX, LA 70301-5079
- **Practice address phone:** (985) 493-3080
- **Practice address fax:** (985) 493-4007
- **Mailing address:** PO BOX 5478, THIBODAUX, LA 70302-5478
- **Mailing address phone:** (985) 493-3080
- **Mailing address fax:** (985) 493-4007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2014
- **Last updated:** 06/02/2025