Gay Gele' Bourgeois, RPSGT, CCSH, RST

Individual provider Active NPI Sleep Disorder Diagnostic Clinic/Center · Lafayette, LA

NPI 1104413004 · NPPES record last updated Dec 25, 2020

Key facts

NPI
1104413004
Entity type
Individual (NPI type 1)
Primary specialty
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
License
POLY.000176 (LA)
Practice address
100 Asma Blvd Ste 205
Lafayette, LA 70508-3842
Phone
(337) 470-3477
Fax
(337) 289-5609
NPI assigned
Dec 25, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
POLY.000176LAMDSleep Disorder Diagnostic Clinic/Center

Interoperability endpoints

  • Direct secure messaging: gay.bourgeois@fmolhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist
Group: 193400000X SINGLE SPECIALTY GROUP
246Z00000X LA
Sleep Disorder Diagnostic Clinic/Center 261QS1200X POLY.000176 LA Yes

Addresses

Primary practice location

100 Asma Blvd Ste 205
Lafayette, LA 70508-3842

Mailing address

1036 Gleaux Dr
Breaux Bridge, LA 70517-3200
Phone (504) 231-4483

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address Gay.Bourgeois@FMOLHS.org

Other providers in Lafayette, LA

All providers in Lafayette, LA · Sleep Disorder Diagnostic Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.