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
Phone: (505) 984-8989
Fax: (505) 984-8892
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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