Wendy L Broussard, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

05101TG Issued in TX

Practice address

138 Gateway St
Beaumont, TX 77701-3706

Phone

(409) 835-2041

Fax

(409) 838-4518

NPI assigned

Aug 10, 2007

Last updated

Apr 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Broussard Eye Associates, LLLP

  • Optometrist
  • Beaumont, TX
  • NPI 1174564280
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1124210547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 GATEWAY ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013706",
            "telephone_number": "409-835-2041",
            "fax_number": "409-838-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 GATEWAY ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013706",
            "telephone_number": "409-835-2041",
            "fax_number": "409-838-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "WENDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05101TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Broussard, PMHNP
• James Coty Broussard, DC
• Juliette R. Broussard, MSN, RN, FNPC
• Kesha Broussard
• Rayfus Joseph Broussard, DDS
• Tonya Renee Brown-Nembhard, M.D.
• Bertron Brown, M.D.
• Connie L Brown, NP
• Deborah Lynne Brown, WHCNP
• Heather Maureen Brown

• Optometrist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.