NPI age
18 years
Enumerated 2008-01-15
● Active
Type 1 · Individual
DR. Mark A Provenzano, O.D.
Provenzano is 1 of 19 optometrist providers in Lake Jackson and 1 of 7867 in Texas.
Primary specialty
Optometrist
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-04-21
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 7867 active optometrist providers in Texas.
NPI age
18 years
↑ 3 yr above median (15 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-01Enumerated in NPPES
2008
2026
Where they practice
Practice location
123 Circle Way
Lake Jackson, TX 775665233
Mailing address
123 Circle Way
Lake Jackson, TX 775665233
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 |
|---|---|---|
| 01 | 80775Q | BC/BS TX |
| 01 | 1073607370 | RAILROAD MEDICARE |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
Recently enumerated nearby: 1 new optometrist provider has been added in Lake Jackson in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.