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

Mark Phillip Provenzano, MD

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1811094584

Mark Phillip Provenzano, MD is an Orthopedic Surgery in Houston, Texas. Graduated from Baylor College of Medicine in 1982, 44 years ago. Practices with Mark Provenzano MD PA, a 5-clinician group. Licensed in Texas.

Years since qualifying
44
Trained at
Baylor College of Medicine
Licensed in
TX
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

950 Campbell Rd
Houston, TX 77024-2804
Phone: (713) 464-0077
Fax: (713) 464-9582
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence G3705 (TX)

Record details

NPI number1811094584
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 17, 2006
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolBAYLOR COLLEGE OF MEDICINE
Graduated 1982 (44 years in practice)
Group practice Mark Provenzano Md Pa — 5 clinicians
Accepts Medicare assignment Not indicated

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