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NPI Code Detail

MEDICARE: HILLARY LUKER GORDON M.S., CCC-SLP

MEDICARE:   HILLARY LUKER GORDON  M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist13960FL
2235Z00000XSpeech-Language Pathologist117506TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275854762
Entity Type Code : Individual
Provider Name (Legal Business Name) : HILLARY LUKER GORDON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 11153 WESTWOOD LOOP STE 123
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-6533
Country : US
Telephone Number : 601-678-2211
Fax Number :
Provider Business Practice Location Address
First Line : 11153 WESTWOOD LOOP STE 123
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-6533
Country : US
Telephone Number : 601-678-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2010
Last Update Date : 12/08/2020

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Directions to “ HILLARY LUKER GORDON M.S., CCC-SLP” Practice Location

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