Provider Demographics
NPI:1861005779
Name:BORDERS, MORGAN BREANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:BREANNA
Last Name:BORDERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E ROUND GROVE RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8301
Mailing Address - Country:US
Mailing Address - Phone:469-549-0987
Mailing Address - Fax:
Practice Address - Street 1:190 E ROUND GROVE RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8301
Practice Address - Country:US
Practice Address - Phone:469-549-0987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10041TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist