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1811094584
MARK PHILLIP PROVENZANO
HOUSTON, TX
NPI
1811094584
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207XX0005X Orthopaedic Surgery, Sports Medicine
(Licence: TX 207XX0005X)
Enumeration Date
2006-09-17
Last Update Date
2014-05-23
Business Address
-- MARK PHILLIP PROVENZANO M.D.
950 CAMPBELL RD
HOUSTON, TX 77024-2804
Phone number: 713-464-0077
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Mailing Address
-- MARK PHILLIP PROVENZANO M.D.
950 CAMPBELL RD
HOUSTON, TX 77024-2804
Phone number: 713-464-0077
Copy
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