MEDICARE: DR. ALLEN BORIS SAFIR O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6651 T	TX
2	152W00000X	Optometrist	OPC 3947	FL

General Provider Information

NPI Number	:	1356385587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN BORIS SAFIR O.D.

Provider Business Mailing Address
First Line	:	4414 LEMMON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2142
Country	:	US
Telephone Number	:	214-522-3937
Fax Number	:	214-520-8646

Provider Business Practice Location Address
First Line	:	4414 LEMMON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2142
Country	:	US
Telephone Number	:	214-522-3937
Fax Number	:	214-520-8646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/09/2007

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