Provider Demographics
NPI:1275854762
Name:GORDON, HILLARY LUKER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:LUKER
Last Name:GORDON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:LUKER
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:11153 WESTWOOD LOOP STE 123
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6533
Mailing Address - Country:US
Mailing Address - Phone:601-678-2211
Mailing Address - Fax:
Practice Address - Street 1:11153 WESTWOOD LOOP STE 123
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-6533
Practice Address - Country:US
Practice Address - Phone:601-678-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13960235Z00000X
TX117506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty