Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum Sole proprietor

Dr. Mark A Provenzano, O.D.

Optometrist in Lake Jackson, TX · enumerated 2008 · practices at Brazosport Professional Eye Clinic Inc.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1942486428

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Registry record

Entity type Individual (Type 1)

Name Dr. Mark A Provenzano

Credential O.D.

Sex Male

Practice address Lake Jackson, TX, 77566

Phone (979) 299-3250

Enumeration date Jan 15, 2008

Last updated in NPPES Apr 21, 2009

Street address withheld: NPPES sole-proprietor addresses can be home addresses. See our data policy.

Taxonomy & licenses

152W00000X Optometrist Eye and Vision Services Providers · License 3979TG (TX) Primary

OD · Doctor of Optometry: A licensed optometrist providing primary vision care, eye exams, and corrective lenses. About the OD credential

Other identifiers

Identifier	Type	State	Issuer
80775Q	Other	-	BC/BS TX
1073607370	Other	-	RAILROAD MEDICARE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What specialty is Mark Provenzano?

Mark Provenzano is registered in NPPES with the primary taxonomy of Optometrist. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

Other providers at this practice address

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Brazosport Professional Eye Clinic Inc Optometrist · Lake Jackson, TX NPI 1073607370

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-04-21.