Provider Demographics
NPI:1972828481
Name:LUEDKE, COLTEN CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:COLTEN
Middle Name:CHRISTOPHER
Last Name:LUEDKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 LONGMIRE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6472
Mailing Address - Country:US
Mailing Address - Phone:979-696-3344
Mailing Address - Fax:
Practice Address - Street 1:3526 LONGMIRE DR STE 200
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6472
Practice Address - Country:US
Practice Address - Phone:979-696-3344
Practice Address - Fax:979-696-5944
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1446207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1972828481OtherORTHIOPEADICS
TX359148901Medicaid