Healthcare Provider Details

I. General information

NPI: 1154590263
Provider Name (Legal Business Name): NAIR ENID BORGES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8880 W. CHARLESTON BLVD.
LAS VEGAS NV
89117-5454
US

IV. Provider business mailing address

8880 W. CHARLESTON BLVD.
LAS VEGAS NV
89117-5454
US

V. Phone/Fax

Practice location:
  • Phone: 702-938-2020
  • Fax: 702-938-2034
Mailing address:
  • Phone: 702-938-2020
  • Fax: 702-938-2034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2636
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number615
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: