Provider Demographics
NPI:1356385587
Name:SAFIR, ALLEN BORIS (OD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:BORIS
Last Name:SAFIR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 LEMMON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-2142
Mailing Address - Country:US
Mailing Address - Phone:214-522-3937
Mailing Address - Fax:214-520-8646
Practice Address - Street 1:4414 LEMMON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-2142
Practice Address - Country:US
Practice Address - Phone:214-522-3937
Practice Address - Fax:214-520-8646
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6651 T152W00000X
FLOPC 3947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611140Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
TXV02298Medicare UPIN