NPI age
19 years
Enumerated 2006-10-03
● Active Type 2 · Organization
Brazosport Professional Eye Clinic Inc
Brazosport Professional Eye Clinic Inc is 1 of 7867 optometrist organizations in Texas.
Primary specialty
Optometrist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Provenzano
Owner
Last NPPES update
2008-12-11
Source: monthly bulk 2026-05
How this organization compares
Across 7867 active optometrist providers in Texas.
NPI age
19 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
123 Circle Way
Lake Jackson, TX 775665233
Mailing address
123 Circle Way
Lake Jackson, TX 775665233
Authorized official
Mark Allen Provenzano, OD
Owner
📞 9792993250
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Mark Provenzano, O.D. Optometrist NPI 1942486428
Specialties
-
Optometrist PrimaryDoctors 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0195042 | |
| 01 (TX) | 80775Q | BCBS OF TX |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Mark A Provenzano OD
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.