Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mark A Provenzano, OD

Individual provider Optometrist · NPI 1942486428

Dr. Mark A Provenzano, OD is an Optometry in Lake Jackson, Texas. Graduated from University of Houston - College of Optometry in 1988, 38 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
38
Trained at
University of Houston - College of Optometry
Licensed in
TX
In the registry since
2008
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

123 Circle Way
Lake Jackson, TX 77566-5233
Phone: (979) 299-3250
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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 number1942486428
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJanuary 15, 2008
Last updated in NPPESApril 21, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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