| Lara Cornelia Thibodeaux, NP | |
|
808 W Us Highway 79, 2880, Franklin, TX 77856 | |
| (979) 282-4540 | |
| (979) 828-3006 |
| Full Name | Lara Cornelia Thibodeaux |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 27 Years |
| Location | 808 W Us Highway 79, Franklin, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902894595 | NPI | - | NPPES |
| 1841562451 | Other | TX | FACILITY NPI (SJHP FRANKLIN) |
| 2952517-01 | Other | TX | BVCAA DBA ST,. JOSEPH HEALTH POINT FRANKLIN MEDICAID (PTAN) NUMBER |
| 67-1981 | Other | TX | BVCAA DBA: ST. JOSEPH HEALTH POINT FRANKLIN PTAN (MEDICARE NUMBER) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 593517 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Home Health United | College station, TX | Home health agency |
| Sienna Home Health Care | Tomball, TX | Home health agency |
| Traditions Health Care | College station, TX | Home health agency |
| St Joseph Regional Health Center | Bryan, TX | Hospital |
| Baylor Scott & White Medical Center- College Stati | College station, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brazos Valley Community Action Agency Inc | 4284542127 | 36 |
| Entity Name | St Joseph Regional Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669557179 PECOS PAC ID: 5294727921 Enrollment ID: O20040401000670 |
| Entity Name | Brazos Valley Community Action Agency Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649265646 PECOS PAC ID: 4284542127 Enrollment ID: O20040708001095 |
| Mailing Address | Practice Location Address |
|---|---|
| Lara Cornelia Thibodeaux, NP 1500 University Dr E, Suite 100, College Station, TX 77840-2600 Ph: (979) 846-1100 | Lara Cornelia Thibodeaux, NP 808 W Us Highway 79, 2880, Franklin, TX 77856 Ph: (979) 282-4540 |
Blake Kent Mcdaniel, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 808 W Us Highway 79, Franklin, TX 77856 Phone: 979-828-1450 Fax: 979-828-1164 |