Mark A Provenzano Od is a Optometrist Center in Lake Jackson, Texas. It is situated at 123 Circle Way, Lake Jackson and its contact number is 979-299-3250. The authorized person of Mark A Provenzano Od is Dr. Mark Allen Provenzano
who is Owner of the clinic and their contact number is 979-299-3250. Primary license number for Mark A Provenzano Od is 3979TG (Optometrist) in Texas. Mark A Provenzano Od Center have optometrists who can 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. Optometrists are eye health care professionals who are state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Center Profile:
Mark A Provenzano Od Center speciality, address, contact phone number and fax are as below.
Patients can call the eye care center on the below given phone number for appointment.
Specialization:
Optometry
Clinic Address:
123 Circle Way, Lake Jackson, Texas, 77566-5233
Phone:
979-299-3250
Fax:
979-299-1724
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Mark Allen Provenzano
Position:
Owner
Contact Number:
979-299-3250
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Mark A Provenzano Od Center are as mentioned below.
NPI Number:
1073607370
NPI Enumeration Date:
03 Oct, 2006
NPI Last Update On:
11 Dec, 2008
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark A Provenzano Od are as mentioned below.
Specialization
License Number
State
Status
Optometrist
3979TG
Texas
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
0195042
Medicaid
Texas
80775Q
Other
Texas
Bcbs Of Tx
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Mark A Provenzano Od 123 Circle Way, Lake Jackson, Texas
Zip:
77566-5233
Phone Number:
979-299-3250
Fax Number:
979-299-1724
Patients can reach Mark A Provenzano Od at 123 Circle Way, Lake Jackson, Texas or can call to book an appointment on 979-299-3250. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.
Comments/ Reviews:
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