Provider Demographics
NPI:1669612891
Name:KUGLEN, CRAIG CHARLES SR (MD,)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:CHARLES
Last Name:KUGLEN
Suffix:SR
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ROCKCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1205
Mailing Address - Country:US
Mailing Address - Phone:512-327-0319
Mailing Address - Fax:
Practice Address - Street 1:1310 ROCKCLIFF RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1205
Practice Address - Country:US
Practice Address - Phone:512-327-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD0574207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology