Provider Demographics
NPI:1700894342
Name:GILEAD HEALTH CARE, INC
Entity Type:Organization
Organization Name:GILEAD HEALTH CARE, INC
Other - Org Name:GILEAD HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FUNMILAYO
Authorized Official - Middle Name:BOSEDE
Authorized Official - Last Name:OGUNLEYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-323-5858
Mailing Address - Street 1:8011B CAMERON RD
Mailing Address - Street 2:200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-3833
Mailing Address - Country:US
Mailing Address - Phone:512-323-5858
Mailing Address - Fax:512-323-5860
Practice Address - Street 1:2300 GREENHILL DR STE 500
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2786
Practice Address - Country:US
Practice Address - Phone:512-323-5858
Practice Address - Fax:512-323-5860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008925251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16751001Medicaid
TX679474Medicare ID - Type Unspecified