Provider Demographics
NPI:1942652706
Name:FAKHRA, SAHBA (OD)
Entity Type:Individual
Prefix:DR
First Name:SAHBA
Middle Name:
Last Name:FAKHRA
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 1:5840 W. CRAIG RD. STE. 120 PMB 254
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130
Mailing Address - Country:US
Mailing Address - Phone:702-724-2020
Mailing Address - Fax:702-724-2800
Practice Address - Street 1:330 S RAMPART BLVD STE 360
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5754
Practice Address - Country:US
Practice Address - Phone:702-724-2020
Practice Address - Fax:702-724-2800
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV913152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist