Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Cardiology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
602 N ACADIA RD STE 101, THIBODAUX, LA 70301-4848
(985) 493-4993
(985) 493-4994
Mailing address
602 N ACADIA RD, CONTRACT MANAGEMENT DEPT., THIBODAUX, LA 70301-4823
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2025
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