Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Multi-Specialty Clinic-Houma
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
1238 SAINT CHARLES ST, HOUMA, LA 70360-2745
(985) 872-9430
(985) 872-9534
Mailing address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 435-4831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084N0400X
Neurology Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
08/13/2021
Last updated
02/20/2024
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