MEDICARE: DEBRA SEMONE BERNARD OD

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	11240T	TX

General Provider Information

NPI Number	:	1144051186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA SEMONE BERNARD OD

Provider Business Mailing Address
First Line	:	603 MEADOW KNOLL DR
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-5916
Country	:	US
Telephone Number	:	908-386-1082
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 SHOTWELL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-4813
Country	:	US
Telephone Number	:	713-766-4456
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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