Organization
GARETT THIBODEAUX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARETT THIBODEAUX OD (OPTOMETRIST)
(337) 332-4473
Entity
Organization
Contact information
Practice address
1525 E BRIDGE ST, BREAUX BRIDGE, LA 70517-3401
(337) 332-4473
(337) 332-4015
Mailing address
1525 E BRIDGE ST, BREAUX BRIDGE, LA 70517-3401
(337) 332-4473
(337) 332-4015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1536-564T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582662
—
LA
Enumeration date
03/13/2012
Last updated
06/13/2012
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