Provider Demographics
NPI:1689881898
Name:BORIC, LAMIA (MD)
Entity Type:Individual
Prefix:
First Name:LAMIA
Middle Name:
Last Name:BORIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:520-519-7700
Mailing Address - Fax:
Practice Address - Street 1:7200 W BELL RD BLDG A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8529
Practice Address - Country:US
Practice Address - Phone:623-487-4822
Practice Address - Fax:602-230-9350
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59285207RX0202X
ORMD153997207RH0003X
UT8928135-1205207RH0003X, 207RX0202X
VA0116017613390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12319797OtherCAQH ID
NV18299OtherNEVADA STATE BOARD OF MEDICAL EXAMINERS
NV18299OtherNEVADA STATE BOARD OF MEDICAL EXAMINERS