DR. WENDY L BROUSSARD (NPI# 1124210547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124210547 |
| Entity Type | Individual |
| Full Name | DR. WENDY L BROUSSARD |
| Credential | OD |
| Practice Address |
138 Gateway St Beaumont TX 77701-3706 |
| Practice Telephone | 4098352041 |
| Practice Fax Number | 4098384518 |
| Mailing Telephone | 4098352041 |
| Mailing Fax Number | 4098384518 |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2015-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 05101TG | TX | Eye and Vision Services Providers |
| Street Address |
138 GATEWAY ST |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77701-3706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174564280 | Tso of Beaumont,llp | Optometrist | 138 Gateway St, Beaumont, TX 77701-3706 | 2006-06-09 |
| 1073993606 | Matthew Phan | Optometrist | 138 Gateway St, Beaumont, TX 77701-3706 | 2015-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891296604 | Jessica Paige Seago | Licensed Vocational Nurse | 3330 Fannin, Beaumont, TX 77701 | 2018-02-27 |
| 1154833135 | Shannon Denard | Naturopath | 1595 S. M.l. King Jr. Parkway, Beaumont, TX 77701 | 2017-10-30 |
| 1558818096 | Kelli North | Nurse Practitioner | 810 Hospital Dr Ste. 235, Beaumont, TX 77701 | 2016-09-01 |
| 1821446055 | La Costa of Beaumont Pa | Dentist | 3870 College Street, Suite #200, Beaumont, TX 77701 | 2016-05-27 |
| 1811361462 | Azuka Ginigeme | Pharmacist | 3605 College Street, Walgreens Pharmacy, Beaumont, TX 77701 | 2015-11-19 |
| 1093184921 | Coastal Spine & Pain Institute, Pllc | Specialist | 3070 College Street, Suite 300, Beaumont, TX 77701 | 2015-09-22 |
| 1831584663 | H-e-b, Lp | Clinical Medical Laboratory | 3590 College Street, Beaumont, TX 77701 | 2015-03-30 |
| 1205272648 | Yalanda S Jessie | Counselor | 755 S 11th St Ste 246, Beaumont, TX 77701 | 2013-05-13 |
| 1871856443 | Henry Clay Williams | Day Training, Developmentally Disabled Services | 2316 Orange St., Beaumont, TX 77701 | 2012-06-19 |
| 1053670398 | Park Infusioncare, Lp | Durable Medical Equipment & Medical Supplies | 3695 Stagg Dr, Beaumont, TX 77701 | 2012-05-07 |
| Find all providers in zip 77701 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972115376 | National Vision Inc | Optometrist | 1561 East 2nd Street, Suite 300, Beaumont, CA 92223 | 2020-08-18 |
| 1558900373 | Med Southwest, Pllc | Optometrist | 6725 Deleware Street, Beaumont, TX 77706-7655 | 2019-12-26 |
| 1639662802 | Jeremy Ball | Optometrist | 1659 E 6th St Ste A, Beaumont, CA 92223 | 2018-06-12 |
| 1710385299 | Daniel & Max, LLC | Optometrist | 4410 Dowlen Rd, Suite 101a, Beaumont, TX 77706-6872 | 2014-12-15 |
| 1427463025 | Phu Nguyen | Optometrist | 1668 E 2nd St, Suite B, Beaumont, CA 92223-3164 | 2014-06-23 |
| 1407096076 | Andrew Mann Optometrist Pa | Optometrist | 2853 Eastex Fwy, Beaumont, TX 77706-3043 | 2009-02-23 |
| 1184889297 | Peter Hoang | Optometrist | 3345 Plaza 10 Dr Ste B, Beaumont, TX 77707-2553 | 2008-07-29 |
| 1891919023 | Mark Alan Johnson | Optometrist | 6155 Eastex Fwy, Suite 699, Beaumont, TX 77706-6718 | 2007-04-12 |
| 1104972140 | Blair M Ball | Optometrist | 1659 E 6th St, Suite A, Beaumont, CA 92223-2509 | 2007-01-25 |
| 1194876151 | John P.s. Yu | Optometrist | 4159 Dowlen Rd, Beaumont, TX 77706-6852 | 2007-01-16 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.