Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Urology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGEMENT)
(985) 493-4907
Entity
Organization
Contact information
Practice address
506 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 493-4907
(985) 449-2585
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 438-4831
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
06/03/2020
Last updated
07/09/2025
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