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NPI Code Detail

MEDICARE: DR. ALBERT THIBEAUX MD

MEDICARE:  DR. ALBERT  THIBEAUX  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianF5066TX

General Provider Information

NPI Number : 1124014303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALBERT THIBEAUX MD
Provider Business Mailing Address
First Line : 2602 SIR GAWAIN LN
Second Line :
City : LEWISVILLE
State : TX
Zip : 75056-5718
Country : US
Telephone Number : 972-899-2477
Fax Number : 972-899-2477
Provider Business Practice Location Address
First Line : 2602 SIR GAWAIN LN
Second Line :
City : LEWISVILLE
State : TX
Zip : 75056-5718
Country : US
Telephone Number : 972-899-2477
Fax Number : 972-899-2477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 07/08/2007

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Directions to “ DR. ALBERT THIBEAUX MD” Practice Location

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