Provider Demographics
NPI:1053142331
Name:MCGILL, ZACHARY CHASE
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CHASE
Last Name:MCGILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8403 CROSS SPG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2508
Mailing Address - Country:US
Mailing Address - Phone:618-472-2965
Mailing Address - Fax:
Practice Address - Street 1:8403 CROSS SPG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2508
Practice Address - Country:US
Practice Address - Phone:618-472-2965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant