Provider Demographics
NPI:1689430225
Name:LU, ANDREW NORMAN (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:NORMAN
Last Name:LU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 W FRYE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5298
Mailing Address - Country:US
Mailing Address - Phone:480-821-1800
Mailing Address - Fax:
Practice Address - Street 1:1727 W FRYE RD STE 220
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5298
Practice Address - Country:US
Practice Address - Phone:480-821-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002769152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist