Provider Demographics
NPI:1245462597
Name:GILHEANY, MICHAEL AUGUSTINE (FNP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:AUGUSTINE
Last Name:GILHEANY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 W HOWARD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6300
Mailing Address - Country:US
Mailing Address - Phone:512-324-8960
Mailing Address - Fax:512-324-8906
Practice Address - Street 1:301 SETON PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8002
Practice Address - Country:US
Practice Address - Phone:512-324-4812
Practice Address - Fax:512-324-4728
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX832N40OtherBCBS
TX209825304Medicaid
TX209825306Medicaid
TX209825305Medicaid
TX209825307Medicaid
TX8216NQOtherBCBS
TX832N40OtherBCBS
TXTXB117123Medicare PIN
TX329669YMGJMedicare PIN
TX329669YL9XMedicare PIN