Provider Demographics
NPI:1194938183
Name:BERCE, DIANE S (OD)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:S
Last Name:BERCE
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 1:7802 CHINON CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3723
Mailing Address - Country:US
Mailing Address - Phone:713-416-7842
Mailing Address - Fax:
Practice Address - Street 1:14215 FM 2100 RD
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-9152
Practice Address - Country:US
Practice Address - Phone:281-328-7888
Practice Address - Fax:281-328-4892
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3610-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist