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NPI 1992247183

NPI 1992247183 : J DEPAUL GAUTREAUX : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1992247183
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    Entity Type          |    Individual 
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    Provider Name        |    J DEPAUL GAUTREAUX
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/05/2016
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    Last Update Date     |    11/05/2016
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Provider Practice Location Address
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    Address Line         |    3016 BUCK ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77020-3821
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    Country              |    US
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    Telephone            |    832-516-3292
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1451 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77251-1451
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    Country              |    US
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    Telephone            |    832-516-3292
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    
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    License Number State |    
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