MARK PROVENZANO MD PA (NPI# 1720261456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720261456 |
| Entity Type | Organization |
| Organization Name | MARK PROVENZANO MD PA |
| Other Organization Name | THE ORTHOPEDIC SPORTS CLINIC |
| Practice Address |
950 Campbell Rd Houston TX 77024-2804 |
| Mailing Address |
Po Box 3961 Houston TX 77253-3961 |
| Practice Telephone | 7134640077 |
| Practice Fax Number | 7134649582 |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | KRISTY MCDOWELL (BILLING/INSURANCE) |
| Authorized Official Telephone | 7134640077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G3705 | TX | Other Service Providers |
| Other Name | Type Code |
|---|---|
| THE ORTHOPEDIC SPORTS CLINIC | Doing Business As Name - Organization |
| Street Address |
950 CAMPBELL RD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77024-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629035894 | Juan C Bustos | Orthopaedic Surgery | 950 Campbell Rd, Houston, TX 77024 | 2006-04-29 |
| 1245795798 | Wesley-viet Dinh Vu | Physical Therapy Assistant | 950 Campbell Rd, Houston, TX 77024-2804 | 2019-02-08 |
| 1093253080 | Wendy Alexander | Specialist/Technologist, Other | 950 Campbell Rd, Houston, TX 77024-2804 | 2017-02-09 |
| 1245782432 | Danielle Marie Lavoy | Physician Assistant | 950 Campbell Rd, Houston, TX 77024-2804 | 2016-11-04 |
| 1144612037 | Badlani Spine & Pain Pllc | Orthopaedic Surgery | 950 Campbell Rd, Houston, TX 77024-2804 | 2015-03-02 |
| 1093948655 | Juan C Bustos Md Pa | Clinic/Center | 950 Campbell Rd, Houston, TX 77024-2804 | 2009-08-31 |
| 1598858565 | Carl Frank Palumbo | Orthopaedic Surgery | 950 Campbell Rd, Houston, TX 77024-2804 | 2006-10-02 |
| 1811094584 | Mark Phillip Provenzano | Orthopaedic Surgery | 950 Campbell Rd, Houston, TX 77024-2804 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154955664 | Candace L Lillibridge | Physical Therapist | 700 Town & Country Blvd, Suite 2490, Houston, TX 77024 | 2020-02-24 |
| 1952940728 | Generations Provider Services LLC | Technician | 12633 Memorial Dr #242 Unit, Houston, TX 77024 | 2019-12-27 |
| 1912540352 | Francesca Penner | Psychologist | 920 Frostwood Drive, Suite 670 and 680, Houston, TX 77024 | 2019-10-17 |
| 1407498553 | Charles Hooks Iv | Technician | 12119 Perthshire Rd, Houston, TX 77024 | 2019-10-10 |
| 1427614379 | Texas Regional Clinic | Pain Medicine | 8301 Katy Freeway, Suite 101, Houston, TX 77024 | 2019-05-16 |
| 1922663871 | Fast Premier Transport LLC | Secured Medical Transport (VAN) | 811 Town and Country Blvd., Suite 141, Houston, TX 77024 | 2019-05-07 |
| 1205317534 | Hiro Health Corporation | Durable Medical Equipment & Medical Supplies | 8584 Katy Freeway, Suite 422, Houston, TX 77024 | 2018-08-24 |
| 1548799901 | K Med Pharmacy | Pharmacy | 11900 Barryknoll #6109, Houston, TX 77024 | 2017-06-08 |
| 1184166712 | Baylor College of Medicine | Clinic/Center | 8660 Memorial Drive, Houston, TX 77024 | 2016-11-14 |
| 1376092197 | Elyse Sears Dds Pllc | Dentist | 803 W Sam Houston Pkwy N, Ste 124, Houston, TX 77024 | 2016-09-22 |
| Find all providers in zip 77024 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949152 | Angelica Rosas-torres | Specialist | 9810 Brick Village Dr, Houston, TX 77095-5072 | 2020-07-16 |
| 1689202004 | Bayou Surgical Assistants Inc | Specialist | 121 N Post Oak Ln Apt 2204, Houston, TX 77024-7717 | 2020-03-31 |
| 1588290761 | Jim Gigante | Specialist | 5607 Fountainbridge Ln, Houston, TX 77069-1917 | 2020-03-19 |
| 1043840044 | Valerie Pedraza | Specialist | 9802d Ella Blvd, Houston, TX 77038-3030 | 2020-01-19 |
| 1386200178 | Thaddieus A Reed | Specialist | 3605 Wilmington St, Houston, TX 77051-3248 | 2019-05-16 |
| 1437617545 | Wellness Institute of Neurodevelopment | Specialist | 5757 Woodway Dr Ste 190, Houston, TX 77057-1526 | 2019-03-07 |
| 1275098568 | Idoc Virtual Telehealth Texas | Specialist | 2311 W Main St, Houston, TX 77098-3218 | 2019-01-31 |
| 1326531708 | Houston Neurology Clinical & Diagnostic Consultants Company | Specialist | 1313 La Concha Ln Ste 130, Houston, TX 77054-1809 | 2018-06-11 |
| 1154840908 | Webster Diagnostics, Pllc | Specialist | 18333 Egret Bay Blvd Ste 200, Houston, TX 77058-3200 | 2017-09-13 |
| 1093242166 | Cns Medical Group | Specialist | 6238 Rietta St, Houston, TX 77016-4338 | 2017-05-18 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.