Mark Phillip Provenzano
M.D. | Sports Medicine | 43+ years Exp
950 Campbell Rd, Houston
Texas, 77024-2804
713-464-0077 713-464-9582
Maps & DirectionsMark Phillip Provenzano is a Houston, Texas based orthopedic surgeon with 43 years of experience in Sports Medicine. He completed his graduation from Baylor College Of Medicine in 1982.. He may accept the Medicare-approved amount. Patients may be billed for more than the Medicare deductible and coinsurance. Active license number of Mark Phillip Provenzano is 207XX0005X for Sports Medicine in Texas.
Mark Phillip Provenzano is trained in sports medicine which help to provide appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Complete Profile:
Mark Phillip Provenzano speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Orthopedic - Sports Medicine |
| Credentials: | M.D. |
| Experience: | 43+ years |
| Medical School Attended: | Baylor College Of Medicine |
| Graduation Year: | 1982 |
| Gender: | Male |
| Accepts Medicare Assignment: | May Accept |
| Practice Address: | 950 Campbell Rd, Houston,
Texas, 77024-2804 |
| Phone: | 713-464-0077 |
| Fax: | 713-464-9582 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 4284786773 |
| Enrollment ID: | I20090714000531 |
| NPI Number: | 1811094584 |
| NPI Enumeration Date: | 17 Sep, 2006 |
| NPI Last Update On: | 23 May, 2014 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark Phillip Provenzano are as mentioned below.
| License Number | Specialization | State | Status | |
| 207XX0005X | Sports Medicine | Texas | Primary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Mark Phillip Provenzano is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Mark Provenzano Md Pa (1557413044) | 4 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mark Phillip Provenzano such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| MDG3705 | Other | Texas | LICENSE NUMBER |
| 0025EP | Other | Texas | BCBS PROVIDER # |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 950 Campbell Rd,
Houston, Texas |
| Zip: | 77024-2804 |
| Phone Number: | 713-464-0077 |
| Fax Number: | 713-464-9582 |
Patients can reach Mark Phillip Provenzano at
950 Campbell Rd, Houston, Texas or can
call to book an appointment on 713-464-0077.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.