Mark A Provenzano Od in Lake Jackson, TX - Medicare Optometrist Provider

Mark A Provenzano Od is a medicare enrolled "Optometrist" provider in Lake Jackson, Texas. Their current practice location is 123 Circle Way, Lake Jackson, Texas. You can reach out to their office (for appointments etc.) via phone at (979) 299-3250.

Mark A Provenzano Od is licensed to practice in Texas (license number 3979TG) and it also participates in the medicare program. Mark A Provenzano Od is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073607370.

Contact Information

	Mark A Provenzano Od
	123 Circle Way, Lake Jackson, TX 77566-5233
	(979) 299-3250
	(979) 299-1724

Map and Direction

Healthcare Provider's Profile

Full Name	Mark A Provenzano Od
Type	Facility
Speciality	Optometrist
Location	123 Circle Way, Lake Jackson, Texas
Accepts Medicare Assignments	Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073607370
Provider Enumeration Date: 10/03/2006
Last Update Date: 12/11/2008

Medicare PECOS Information:

PECOS PAC ID: 6800973025
Enrollment ID: O20080411000168

Medical Identifiers

Medical identifiers for Mark A Provenzano Od such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073607370	NPI	-	NPPES
0195042	Medicaid	TX
80775Q	Other	TX	BCBS OF TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	3979TG (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Mark A Provenzano Od acts as a billing entity for following providers:

Provider Name	Mark A Provenzano
Provider Type	Practitioner - Optometry
Provider Identifiers	NPI Number: 1942486428 PECOS PAC ID: 8224198916 Enrollment ID: I20081126000099

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. Mark A Provenzano Od is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mark A Provenzano Od 123 Circle Way, Lake Jackson, TX 77566-5233 Ph: (979) 299-3250	Mark A Provenzano Od 123 Circle Way, Lake Jackson, TX 77566-5233 Ph: (979) 299-3250

Reviews and Comments

Optometrist in Lake Jackson, TX

Dr. Julie Nguyen Optometrist Medicare: Not Enrolled in Medicare Practice Location: 121 Highway 332 W, Suite 100, Lake Jackson, TX 77566 Phone: 979-480-9424 Fax: 979-480-9426
The Eye Contact, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4 W Way Ct, Lake Jackson, TX 77566 Phone: 979-297-3937 Fax: 979-297-9889
Dr. Julie Thuydung Nguyen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 121 Highway 332 W, 100, Lake Jackson, TX 77566 Phone: 979-480-9424 Fax: 979-480-9426
Robert G. Haws, O.d. P.a. Optometrist Medicare: Medicare Enrolled Practice Location: 126 Oyster Creek Dr Ste A, Lake Jackson, TX 77566 Phone: 979-299-0100 Fax: 979-299-6181
Dr. William Jackson Jr., O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4 West Way Court, Lake Jackson, TX 77566 Phone: 979-297-3937 Fax: 979-297-9889
Texas State Optical Optometrist Medicare: Medicare Enrolled Practice Location: 120 Highway 332 W, Suite A5, Lake Jackson, TX 77566 Phone: 979-297-3095 Fax: 979-297-5410

Mark A Provenzano Od - Medicare Optometrist in Lake Jackson, TX