Provider Demographics
NPI:1992708606
Name:BERNAY, DEBORAH (OD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BERNAY
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 1:401 W FAIRMONT PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-6307
Mailing Address - Country:US
Mailing Address - Phone:281-471-6546
Mailing Address - Fax:281-471-3411
Practice Address - Street 1:401 W FAIRMONT PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-6307
Practice Address - Country:US
Practice Address - Phone:281-471-6546
Practice Address - Fax:281-471-3411
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3011TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112415802Medicaid
TX4546690OtherAETNA
TX112415802Medicaid
TX0901160001Medicare NSC
TX8F21729Medicare PIN