Organization
THIBODAUX VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JOSEPH ROY III OD (PRESIDENT)
(985) 446-1717
Entity
Organization
Contact information
Practice address
640 ST CHARLES ST, THIBODAUX, LA 70301
(985) 446-1717
(985) 446-9542
Mailing address
PO BOX 72, THIBODAUX, LA 70301-0072
(985) 446-1717
(985) 446-9542
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1354488T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1128015
—
LA
Enumeration date
03/25/2008
Last updated
03/25/2008
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