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General NPI Number Information
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NPI Number | 1295957645
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Entity Type | Organization
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Legal Business Name | RENO FAMILY EYE CARE R ANDREW BOREN OD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 6360 MAE ANNE AVE. SUITE 1
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City | RENO
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State | NV
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Zip | 89523-4710
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Country | US
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Telephone | 775-787-9137
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Fax | 775-323-3652
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Provider Business Mailing Address
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Address Line | 6360 MAE ANNE AVE. SUITE 1
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City | RENO
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State | NV
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Zip | 89523-4710
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Country | US
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Telephone | 775-787-9137
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Fax | 775-323-3652
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD ANDREW BOREN
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Credential | O.D.
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Telephone | 775-787-9137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 354
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 354
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 354
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 354
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License Number State | NV
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