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Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Weight Management Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
604 N ACADIA RD, STE 406, THIBODAUX, LA 70301-4897
(985) 493-4130
(985) 493-4131
Mailing address
602 NORTH ACADIA ROAD, CONTRACT MANAGEMENT DEPT., THIBODAUX, LA 70301
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
NULL
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
NULL
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
04/10/2024
Last updated
04/24/2026
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