MEDICARE: BESSIE GOUDEAU DBA ASAP PROFESSIONAL HOME HEALTH

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
1	251E00000X	Home Health Agency	001212	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619010485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BESSIE GOUDEAU DBA ASAP PROFESSIONAL HOME HEALTH

Provider Business Mailing Address
First Line	:	11821 I-10 EAST FWY
Second Line	:	SUITE 340
City	:	HOUSTON
State	:	TX
Zip	:	77029-2024
Country	:	US
Telephone Number	:	713-455-5979
Fax Number	:	713-450-1845

Provider Business Practice Location Address
First Line	:	11821 I-10 EAST FWY
Second Line	:	SUITE 340
City	:	HOUSTON
State	:	TX
Zip	:	77029-2024
Country	:	US
Telephone Number	:	713-455-5979
Fax Number	:	713-450-1845

Authorized Official
Title or Position	:	OWNER CEO
Name	:	MRS. BESSIE MAE GOUDEAU
Credential	:
Telephone Number	:	713-455-5979

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2008

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