Healthcare Provider Details

I. General information

NPI: 1306327374
Provider Name (Legal Business Name): SARA A MCGILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 E 6TH ST STE 300
BONHAM TX
75418-4094
US

IV. Provider business mailing address

789 COUNTY ROAD 15300
DEPORT TX
75435-3014
US

V. Phone/Fax

Practice location:
  • Phone: 903-583-6155
  • Fax:
Mailing address:
  • Phone: 430-900-8368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114869
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: