Provider Demographics
NPI:1508453176
Name:MCGILL, LAURA JILL (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JILL
Last Name:MCGILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:COPELAND
Other - Last Name:MCGILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-0400
Mailing Address - Country:US
Mailing Address - Phone:903-849-6442
Mailing Address - Fax:903-849-5627
Practice Address - Street 1:201 STATE HIGHWAY 31 E
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758-2378
Practice Address - Country:US
Practice Address - Phone:903-849-6442
Practice Address - Fax:903-849-5627
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX28383OtherTEXAS STATE BOARD OF PHARMACY