Provider Demographics
NPI:1750419636
Name:BECHTER, DORIS (CDE)
Entity type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:
Last Name:BECHTER
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 W THUNDERBIRD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4876
Mailing Address - Country:US
Mailing Address - Phone:602-439-9000
Mailing Address - Fax:602-978-5233
Practice Address - Street 1:5130 W THUNDERBIRD RD STE 1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4876
Practice Address - Country:US
Practice Address - Phone:602-439-9000
Practice Address - Fax:602-978-5233
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0931-5024133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ69403Medicare ID - Type UnspecifiedMEDICARE NUMBER
AZZ120741Medicare PIN