THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION NPI 1396570511

NPI Information

  • NPI: 1396570511
  • Provider Name: THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 19D2311853
  • Address: 604 N ACADIA RD
    STE 406A
    THIBODAUX, LA
    ZIP 70301
  • Phone: (985) 493-3034

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NPI Details

THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION is a family medicine in Thibodaux, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION NPI is 1396570511. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

604 N ACADIA RD
STE 406A
THIBODAUX, LA
ZIP 70301-897
Phone: (985) 493-3034
Fax: (985) 493-3035

The provider's authorized official is Kim Legendre Boudreaux .
The authorized official title is Director Of Contracting and has the following contact phone number (985) 493-4907.

The CLIA number assigned to this NPI record is 19D2311853 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/6/2024 and was last updated on 6/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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