Provider Demographics
NPI:1619010485
Name:BESSIE GOUDEAU DBA ASAP PROFESSIONAL HOME HEALTH
Entity Type:Organization
Organization Name:BESSIE GOUDEAU DBA ASAP PROFESSIONAL HOME HEALTH
Other - Org Name:BESSIE M GOUDEAU DBA ASAP PROFESSIONAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BESSIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:GOUDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-455-5979
Mailing Address - Street 1:11821 I-10 EAST FWY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-2024
Mailing Address - Country:US
Mailing Address - Phone:713-455-5979
Mailing Address - Fax:713-450-1845
Practice Address - Street 1:11821 I-10 EAST FWY
Practice Address - Street 2:SUITE 340
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2024
Practice Address - Country:US
Practice Address - Phone:713-455-5979
Practice Address - Fax:713-450-1845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001212251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000126400Medicaid