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
1	235Z00000X	Speech-Language Pathologist	13960	FL
2	235Z00000X	Speech-Language Pathologist	117506	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID 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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