Basic Information
| Provider Information | |||||||||
| NPI: | 1891156709 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOCKELMAN | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | KAHLE | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3551 ROGER BROOKE DR | ||||||||
| Address2: | SAN ANTONIO MILITARY MEDICAL CENTER | ||||||||
| City: | JBSA FT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109164789 | ||||||||
| FaxNumber: | 2109166654 | ||||||||
| Practice Location | |||||||||
| Address1: | 3551 ROGER BROOKE DR | ||||||||
| Address2: | SAN ANTONIO MILITARY MEDICAL CENTER | ||||||||
| City: | JBSA FT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109164789 | ||||||||
| FaxNumber: | 2109166654 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2016 | ||||||||
| LastUpdateDate: | 03/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208D00000X | R5844 | TX | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.