Provider Demographics
NPI:1932499183
Name:SPILLER, LORA (MD)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:
Last Name:SPILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR # MC7977
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-704-3800
Mailing Address - Fax:210-704-0065
Practice Address - Street 1:315 N SAN SABA STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3193
Practice Address - Country:US
Practice Address - Phone:210-704-3800
Practice Address - Fax:210-704-0065
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ42962080C0008X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386244301Medicaid
TX386244302OtherCSHCN