| Marc Provenzano, | |
|
493 N Main St, Groveton, TX 75845-2498 | |
| (281) 515-8349 | |
| Not Available |
| Full Name | Marc Provenzano |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 493 N Main St, Groveton, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285413922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2100X | Nurse Practitioner - Acute Care | 1119122 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chi St Lukes Health Memorial Livingston | Livingston, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hospitalist Medicine Physicians Of Texas Pllc | 3476688318 | 685 |
| Entity Name | Hospitalist Medicine Physicians of Texas PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629307095 PECOS PAC ID: 3476688318 Enrollment ID: O20100317001021 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Provenzano, Po Box 395, Groveton, TX 75845-0395 Ph: Not Available | Marc Provenzano, 493 N Main St, Groveton, TX 75845-2498 Ph: (281) 515-8349 |
Cecilia Dixon, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 180 Magee Ln, Groveton, TX 75845 Phone: 936-642-0841 |
Melanie L Parker, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 110 Magee, Groveton, TX 75845 Phone: 936-642-0841 |