Provider Demographics
NPI:1003969882
Name:GABRIEL HOME CARE
Entity type:Organization
Organization Name:GABRIEL HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:OLADELE
Authorized Official - Last Name:ODEBUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:M SC
Authorized Official - Phone:713-334-2881
Mailing Address - Street 1:7100 REGENCY SQUARE BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3202
Mailing Address - Country:US
Mailing Address - Phone:713-334-2881
Mailing Address - Fax:713-334-2886
Practice Address - Street 1:7100 REGENCY SQUARE BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3202
Practice Address - Country:US
Practice Address - Phone:713-334-2881
Practice Address - Fax:713-334-2886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007455251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007455OtherAGENCY LICENSE NUMBER
TX007455OtherAGENCY LICENSE NUMBER