DR. Mark Anthony Licatino, O.D.

NPI #1083690051 in Bastrop, Texas

Provider Information

NPI Number: 1083690051
Entity Type: Individual
Name: DR. Mark Anthony Licatino, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Dec 21, 2005
Last Updated: Feb 1, 2010

Practice Location

Address: 85 LOOP 150 W
City: Bastrop
State: Texas
ZIP Code: 78602-3930
Phone: (512) 303-7300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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