Provider Demographics
NPI:1770848954
Name:MCCLURE, ASHLEY FAYE (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:FAYE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23823 CASTLE PEAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-307-9389
Mailing Address - Fax:
Practice Address - Street 1:8403 STATE HIGHWAY 151
Practice Address - Street 2:STE B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2199
Practice Address - Country:US
Practice Address - Phone:210-354-2020
Practice Address - Fax:210-558-9622
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8038T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist