Provider Demographics
NPI:1144051186
Name:BERNARD, DEBRA SEMONE (OD)
Entity type:Individual
Prefix:
First Name:DEBRA SEMONE
Middle Name:
Last Name:BERNARD
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 1:603 MEADOW KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5916
Mailing Address - Country:US
Mailing Address - Phone:908-386-1082
Mailing Address - Fax:
Practice Address - Street 1:711 SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-4813
Practice Address - Country:US
Practice Address - Phone:713-766-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11240T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist