Provider Demographics
NPI:1992247183
Name:GAUTREAUX, J DEPAUL
Entity type:Individual
Prefix:
First Name:J DEPAUL
Middle Name:
Last Name:GAUTREAUX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1451
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77251-1451
Mailing Address - Country:US
Mailing Address - Phone:832-516-3292
Mailing Address - Fax:
Practice Address - Street 1:3016 BUCK ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-3821
Practice Address - Country:US
Practice Address - Phone:832-516-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-05
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)