Thibodeaux, Brent C

Thibodeaux, Brent C is an individual health care provider with primary practice located at 11445 Sunset Hills Rd Kaiser Permanente Reston Medical Center, Reston VA 20190-5276. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Thibodeaux, Brent C can be contacted via phone (703) 709-1500.

Contact Information

Primary practice address
11445 Sunset Hills Rd Kaiser Permanente Reston Medical Center Reston VA 20190-5276
Phone: (703) 709-1500
Fax: (703) 709-1711
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D61216 Maryland
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD034757 District of Columbia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101057696 Virginia

Profile Details

NPI number 1386705721
LBN Legal business name Thibodeaux, Brent C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jun 23rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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