Provider Demographics
NPI:1528187721
Name:SAFIR, BORIS
Entity Type:Individual
Prefix:MR
First Name:BORIS
Middle Name:
Last Name:SAFIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8989 SKILLMAN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8213
Mailing Address - Country:US
Mailing Address - Phone:214-341-2023
Mailing Address - Fax:214-341-2024
Practice Address - Street 1:8989 SKILLMAN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8213
Practice Address - Country:US
Practice Address - Phone:214-341-2023
Practice Address - Fax:214-341-2024
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDR3723156FC0800X
TXDR3722156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019748501Medicaid
TX18099OtherDAVIS VISION
TX752124243OtherHEALTH SMART
TX918255OtherBLOCK VISION
TX752124243OtherVSP
TX27088OtherSPECTERA
TX752124243OtherSUPERIOR VISION
TXTX3723OtherEYEMED