Provider Demographics
NPI:1700125960
Name:BECHTLE, CHAD (OD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:BECHTLE
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 1:4175 S. ALAMO AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS-MONTHAN AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85707
Mailing Address - Country:US
Mailing Address - Phone:520-228-2737
Mailing Address - Fax:
Practice Address - Street 1:4175 S. ALAMO AVE
Practice Address - Street 2:
Practice Address - City:DAVIS-MONTHAN AFB
Practice Address - State:AZ
Practice Address - Zip Code:85707
Practice Address - Country:US
Practice Address - Phone:520-228-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6187152W00000X
UT9426413-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist