Individual provider Active NPI

Debra Semone Bernard, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1144051186
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11240T Issued in TX
Practice address
711 Shotwell St
Houston, TX 77020-4813
Phone
(713) 766-4456
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11240T TX Primary

Addresses

Primary practice location

711 Shotwell St
Houston, TX 77020-4813

Mailing address

603 Meadow Knoll Dr
Stafford, TX 77477-5916
Phone (908) 386-1082

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260302001030 TX Practitioner - Optometry 5698257574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

5505 W Orem Dr
Suite 400
Houston, TX 77085-1278
Phone (713) 257-8612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11240TXMDChiropractor
11240TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Maxwell a. Olumba, O.D., P.a. Optometrist CurrentSince Jan 14, 2026 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jan 14, 2026 Accepting new patients

Locations

5505 W Orem Dr
Ste 400
Houston, TX 77085
Phone (713) 487-2020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1144051186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MEADOW KNOLL DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775916",
            "telephone_number": "908-386-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SHOTWELL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770204813",
            "telephone_number": "713-766-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "DEBRA SEMONE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11240T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.