Provider Demographics
NPI:1063719870
Name:SPILLER, REED B (CCCA)
Entity type:Individual
Prefix:MR
First Name:REED
Middle Name:B
Last Name:SPILLER
Suffix:
Gender:M
Credentials:CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W FRANK ST
Mailing Address - Street 2:STE. 301
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3392
Mailing Address - Country:US
Mailing Address - Phone:936-639-1740
Mailing Address - Fax:936-639-1734
Practice Address - Street 1:1111 W FRANK ST
Practice Address - Street 2:STE. 301
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3392
Practice Address - Country:US
Practice Address - Phone:936-639-1740
Practice Address - Fax:936-639-1734
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51419231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist