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1811322605
MEREDITH WADE THIBODEAUX
SHREVEPORT, LA
NPI
1811322605
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Former Name
MEREDITH ANN WADE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 200668)
Enumeration Date
2013-09-11
Last Update Date
2015-12-10
Business Address
Mrs. MEREDITH WADE THIBODEAUX P.A.-C
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-4394
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Mailing Address
Mrs. MEREDITH WADE THIBODEAUX P.A.-C
479 HOLOMON LOOP
DUBBERLY, LA 71024-2747
Phone number: 318-564-8781
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