Brazosport Professional Eye Clinic Inc
NPI 1073607370 · Optometrist · Lake Jackson, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Brazosport Professional Eye Clinic Inc is a Optometrist organization in Lake Jackson, TX (NPI 1073607370).
Provider details
- NPI number
- 1073607370
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Mark Provenzano, Owner(979) 299-3250
- License
- 3979TG (TX)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Mark a Provenzano OD
Registry dates
- Enumerated
- 2006-10-03
- Last updated
- 2008-12-11
Frequently asked questions
- What is Brazosport Professional Eye Clinic Inc's NPI number?
- Brazosport Professional Eye Clinic Inc's National Provider Identifier (NPI) is 1073607370, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Brazosport Professional Eye Clinic Inc?
- Brazosport Professional Eye Clinic Inc is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Brazosport Professional Eye Clinic Inc located?
- Brazosport Professional Eye Clinic Inc's practice location on file with NPPES is 123 Circle Way, Lake Jackson, TX 77566-5233.
- What is Brazosport Professional Eye Clinic Inc's phone number?
- The practice phone number listed in the NPPES registry for Brazosport Professional Eye Clinic Inc is (979) 299-3250.
- Does Brazosport Professional Eye Clinic Inc accept Medicare?
- Brazosport Professional Eye Clinic Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Brazosport Professional Eye Clinic Inc?
- The authorized official listed on Brazosport Professional Eye Clinic Inc's NPPES record is Mark Provenzano, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Brazosport Professional Eye Clinic Inc's NPI active?
- Yes — Brazosport Professional Eye Clinic Inc's NPI (1073607370) is active in the NPPES registry as of the last update on 2008-12-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.