Thibodeaux Medical Clinic | |
610 Strickland Dr Ste 130 Orange TX 77630-4788 | |
(409) 330-4885 | |
(409) 250-3020 |
Full Name | Thibodeaux Medical Clinic |
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Speciality | Clinic/Center |
Location | 610 Strickland Dr Ste 130, Orange, Texas |
Authorized Official Name and Position | Derrick Thibodeaux (OWNER) |
Authorized Official Contact | 4093304885 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Thibodeaux Medical Clinic 1303 Horridge St Vinton LA 70668-4531 Ph: (337) 324-8060 | Thibodeaux Medical Clinic 610 Strickland Dr Ste 130 Orange TX 77630-4788 Ph: (409) 330-4885 |
NPI Number | 1396455036 |
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Provider Enumeration Date | 12/05/2022 |
Last Update Date | 12/28/2022 |
Medicare PECOS PAC ID | 7416327309 |
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Medicare Enrollment ID | O20230111000506 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396455036 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Micca Riedel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538439385 PECOS PAC ID: 8224299557 Enrollment ID: I20120413000350 |
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Dr. Hamid Reza Jalali, D.o., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11946 Hwy 62 North, Orange, TX 77632 Phone: 409-745-4421 | |
Gulfcoast Cardiology Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Strickland Dr, Ste 370, Orange, TX 77630 Phone: 409-963-0000 Fax: 409-963-1899 | |
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