NPI | 1598029308 |
---|---|
Doing Business As | DWIGHT THIBODEAUX |
Entity Type | Organization |
Authorized Contact | DWIGHT THIBODEAUX Optometrist / Owner 505-984-8989 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NM NM300) |
Enumeration Date | 2012-06-26 |
Last Update Date | 2012-10-25 |