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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
22080 LA HWY 20, VACHERIE, LA 70090-0000
(985) 493-4993
(985) 493-4994
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4740

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
11/22/2023
Last updated
11/22/2023
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