Provider Demographics
NPI:1174070320
Name:CRADER, LUKE (OD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:CRADER
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 1:2430 S I 35 E STE 156
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4989
Mailing Address - Country:US
Mailing Address - Phone:940-484-8857
Mailing Address - Fax:
Practice Address - Street 1:2430 S I 35 E STE 156
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4989
Practice Address - Country:US
Practice Address - Phone:940-484-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9099T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist