Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Pulmonology & Critical Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
(985) 493-4907
Entity
Organization
Contact information
Practice address
604 N ACADIA RD, STE 411, THIBODAUX, LA 70301-4851
(985) 493-4933
(985) 493-4934
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 493-4933
(985) 493-4934
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2336673
—
LA
Enumeration date
02/25/2013
Last updated
06/02/2025
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