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Individual

SEAN MCGILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1636 HUNTERS GLEN RD, SAN ANGELO, TX 76901-5016
(325) 949-5722
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(325) 949-5722
(325) 949-0003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
BP10053424
TX
2084P0800X
Psychiatry Physician
Primary
R1417
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1C1361
MEDICARE
TX
Enumeration date
04/28/2015
Last updated
07/02/2020
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