Provider Demographics
NPI:1215545900
Name:DILLARD, CAYLA JACQUELINE
Entity Type:Individual
Prefix:
First Name:CAYLA
Middle Name:JACQUELINE
Last Name:DILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4975 FM 1549
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:TX
Mailing Address - Zip Code:78011-3435
Mailing Address - Country:US
Mailing Address - Phone:830-480-3188
Mailing Address - Fax:
Practice Address - Street 1:4975 FM 1549
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:TX
Practice Address - Zip Code:78011-3435
Practice Address - Country:US
Practice Address - Phone:830-480-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX978650163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics