Provider Demographics
NPI:1881124329
Name:KRYDER, ANDREW (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:KRYDER
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 1:6851 VIRGINIA PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5622
Mailing Address - Country:US
Mailing Address - Phone:214-865-6266
Mailing Address - Fax:214-865-6305
Practice Address - Street 1:6851 VIRGINIA PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:214-865-6266
Practice Address - Fax:214-865-6305
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9452TG152WL0500X, 152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program