Provider Demographics
NPI:1871727032
Name:DAVID J BEECHER, O.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DAVID J BEECHER, O.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEECHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-826-2139
Mailing Address - Street 1:5400 MEADOWOOD MALL CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6508
Mailing Address - Country:US
Mailing Address - Phone:775-826-2139
Mailing Address - Fax:775-827-3061
Practice Address - Street 1:5400 MEADOWOOD MALL CIR
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6508
Practice Address - Country:US
Practice Address - Phone:775-826-2139
Practice Address - Fax:775-827-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-03
Last Update Date:2009-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV636152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty