Provider Demographics
NPI:1720070188
Name:MCCLUER, CRAIG ANTHONY (OD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:ANTHONY
Last Name:MCCLUER
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 1:2131 PEPPERRELL ST STE 1
Mailing Address - Street 2:BLDG 3350 / OPTOMETRY
Mailing Address - City:LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5313
Mailing Address - Country:US
Mailing Address - Phone:210-292-6582
Mailing Address - Fax:210-292-7062
Practice Address - Street 1:2131 PEPPERRELL ST
Practice Address - Street 2:BLDG 3350 / OPTOMETRY
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5313
Practice Address - Country:US
Practice Address - Phone:210-292-6582
Practice Address - Fax:210-292-7062
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4953/T1823152W00000X
TX5694TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist