Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Pain Clinic, Thibodaux Regional Network Development Corporation-Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
(985) 493-4907
Entity
Organization
Contact information
Practice address
726 N ACADIA RD, STE 2400, THIBODAUX, LA 70301-5078
(985) 493-4090
(985) 493-4081
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 493-4004
(985) 493-4007
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2395131
—
LA
Enumeration date
11/20/2013
Last updated
06/02/2025
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