Healthcare Provider Details

I. General information

NPI: 1699622027
Provider Name (Legal Business Name): TERREBONNE GENERAL FAMILY MEDICINE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 LIBERTY ST
HOUMA LA
70360-4622
US

IV. Provider business mailing address

8166 MAIN ST
HOUMA LA
70360-3404
US

V. Phone/Fax

Practice location:
  • Phone: 985-873-4751
  • Fax: 985-873-4640
Mailing address:
  • Phone: 985-873-4751
  • Fax: 985-873-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CORY JUDE LEONARD
Title or Position: VP OF FINANCE
Credential: LEONARD
Phone: 985-873-4751