Thibodeaux, Dwight

Thibodeaux, Dwight is an individual health care provider with primary practice located at 1409 Luisa St Suite D, Santa Fe NM 87505-7002. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Thibodeaux, Dwight can be contacted via phone (505) 984-8989.

Contact Information

Primary practice address
1409 Luisa St Suite D Santa Fe NM 87505-7002
Fax: (505) 984-8892
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 300 New Mexico

Profile Details

NPI number 1962516039
LBN Legal business name Thibodeaux, Dwight
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Feb 28th, 2008 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962516039 NPPES
New Mexico Other 201009924 PRESBYTERIAN HEALTH PLAN
New Mexico Other 850448729T PRESBYTERIAN HEALTH PLAN
New Mexico Other 850448729 PRESBYTERIAN HEALTH PLAN
New Mexico Other UNITED HEALTH CARE PRESBYTERIAN HEALTH PLAN

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