Active NPI
Craig Anthony McCluer, O.D.
- Optometrist
- Lackland Afb, TX
National Provider Identifier
1720070188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5694TG
- Practice address
- 2131 Pepperrell St
BLDG 3350 / Optometry
Lackland Afb, TX 78236-5313 - Phone
- (210) 292-6582
- Fax
- (210) 292-7062
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4953/T1823 | OH | |
| Optometrist | 152W00000X | 5694TG | TX | Primary |
Addresses
Primary practice location
2131 Pepperrell St
BLDG 3350 / Optometry
Lackland Afb, TX 78236-5313
Mailing address
2131 Pepperrell St Ste 1
BLDG 3350 / Optometry
Lackland Afb, TX 78236-5313
Phone (210) 292-6582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4953/T1823 | OH | MD | Optometrist |
| 5694TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1720070188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2131 PEPPERRELL ST STE 1",
"address_2": "BLDG 3350 / OPTOMETRY",
"city": "LACKLAND AFB",
"state": "TX",
"postal_code": "782365313",
"telephone_number": "210-292-6582",
"fax_number": "210-292-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 PEPPERRELL ST",
"address_2": "BLDG 3350 / OPTOMETRY",
"city": "LACKLAND AFB",
"state": "TX",
"postal_code": "782365313",
"telephone_number": "210-292-6582",
"fax_number": "210-292-7062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLUER",
"first_name": "CRAIG",
"middle_name": "ANTHONY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "4953/T1823",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5694TG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lackland Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.