National Provider Identifier Database

MARK A LICATINO, OD – NPI #1083690051
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

MARK A LICATINO, OD
85 LOOP 150 W
BASTROP, TX78602-3930
Phone: 512-303-7300
Fax: 512-303-2148
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for MARK A LICATINO

NPI Number 1083690051
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 12/21/2005
Last updated 02/01/2010 - About 16 years ago
Sole proprietor1 No
Identifiers
  • TX License #: 2442TG
  • TX Medicaid: 117899802
  • TX Medicaid: 117899803
  • Other: 146573100 FIRST CARE
  • Other: VP11653 GE WELLNESS
  • NY Other: 32787-013 DAVIS VISION
  • OH Other: TX2442 EYEMED
  • TX Other: 4511497 AETNA
  • TX Other: 10013121 AMERIGROUP
  • TX Other: 911390 BLOCK VISION
  • TX Other: 88Y393 BLUE CROSS BLUE SHIELD
  • TX Other: 8114413 BLUELINK
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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