Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brazosport Professional Eye Clinic Inc

Organization Optometrist · NPI 1073607370

Brazosport Professional Eye Clinic Inc is an Optometrist in Lake Jackson, Texas. Licensed in Texas. Registered with an NPI since 2006.

Licensed in
TX
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

123 Circle Way
Lake Jackson, TX 77566-5233
Phone: (979) 299-3250
Fax: (979) 299-1724
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3979TG (TX)

Record details

NPI number1073607370
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Provenzano — Owner · (979) 299-3250
Other names Mark A Provenzano Od
NPI enumeratedOctober 3, 2006
Last updated in NPPESDecember 11, 2008
Mailing address123 Circle Way, Lake Jackson, TX 77566-5233

Other providers in Lake Jackson