Individual
DR. GARETT PAUL THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1525 E BRIDGE ST, BREAUX BRIDGE, LA 70517-3401
(337) 332-4473
(337) 332-4015
Mailing address
406 QUAIL DR, LAFAYETTE, LA 70508-6128
(337) 706-7256
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1536
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582662
—
LA
Enumeration date
08/01/2006
Last updated
09/13/2012
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