Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK A PROVENZANO, O.D.
Active Sole ProprietorDR. MARK A PROVENZANO, O.D. is a Optometrist healthcare provider located in LAKE JACKSON, Texas. NPI 1942486428 is currently active in the NPPES registry. Verify at CMS.
Optometrist · LAKE JACKSON, TX
Registration Details
- NPI Number
- 1942486428
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 15, 2008 (18.395300050859 yrs)
- Last Updated
- Apr 21, 2009
- License
-
3979TG (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
123 CIRCLE WAYLAKE JACKSON, TX, 775665233Browse TX providers · Browse ZIP 77566
- Phone
- 9792993250
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in LAKE JACKSON, TX
| Name | Credential | NPI |
|---|---|---|
| DR. JORGE ENRIQUE GARRETT | OD | 1609898212 |
| DR. ROBERT G HAWS | O.D. | 1710076021 |
| DR. WILLIAM JACKSON JR. | O.D. | 1326109661 |
| BRIAN K SHANDLEY | OD | 1912104969 |
| DR. JULIE THUYDUNG NGUYEN | OD | 1174713077 |
| KAYLA H DAO | O.D. | 1649506981 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.