Marc Provenzano, is a
Nurse Practitioner - Acute Care based in Groveton, Texas. Marc Provenzano is licensed to practice in Texas (license number 1119122) and his current practice location is
493 N Main St, Groveton, Texas. He can be reached at his office (for appointments etc.) via phone at
(281) 515-8349.
NPI number for Marc Provenzano is 1285413922 and his current mailing address is Po Box 395, Groveton, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1285413922.
Provider's Profile
| Full Name | Marc Provenzano |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 493 N Main St, Groveton, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1285413922
- Provider Enumeration Date: 09/22/2023
- Last Update Date: 10/08/2024
Medical Identifiers
Medical identifiers for Marc Provenzano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285413922 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LA2100X | Nurse Practitioner - Acute Care | 1119122 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marc Provenzano is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Marc Provenzano,
Po Box 395,
Groveton, TX 75845-0395
Ph: () - | Marc Provenzano,
493 N Main St,
Groveton, TX 75845-2498
Ph: (281) 515-8349 |
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