Ethan Graham Chandler, OD
Individual provider Active NPI Optometrist · Bixby, OK
NPI 1184553554 · NPPES record last updated Jul 21, 2026
Key facts
- NPI
- 1184553554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- STUDENT (OK)
- Practice address
- 11920 S Memorial Dr
Bixby, OK 74008-2170 - Phone
- (316) 650-9939
- NPI assigned
- May 14, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| STUDENT | OK | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | STUDENT | OK | Yes |
Addresses
Primary practice location
11920 S Memorial Dr
Bixby, OK 74008-2170
Mailing address
3505 W 112TH St S
Jenks, OK 74037-2493
Phone (316) 650-9939
Other providers in Bixby, OK
- Katie Cariker
- Kaylor Carlton
- Carter Healthcare DME of Northeast Oklahoma LLC
- Carter Healthcare Hospice of Northeast Oklahoma, LLC
- Carter Healthcare of Northeast Oklahoma, LLC
- Ashtyn Skylar Cherrington
- David Noel Chorley
- Christopher Trockel Orthodontics PC
- Hannah Victoria Christopherson
- City of Bixby
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.