Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083690051 Individual Practitioner Male Practitioner

Dr. Mark Anthony Licatino , OD

Optometrist • Bastrop, TX

Professional Overview & Biography Verified Profile Summary

Dr. Mark Licatino, OD is a registered healthcare professional specializing in Optometrist in Bastrop, TX. Practice services are available at 85 LOOP 150 W under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

85 Loop 150 W

Bastrop, TX 786023930

Telephone 5123037300
Fax 5123032148
Associated Practice Facility / Clinic
🏢 Atlas Pain Institute, Llc Facility NPI 1710059126

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Bastrop, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.9 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
14 Specialists

Practicing in Bastrop, TX (5156 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License TX 2442TG

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. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
117899802 (TX)
Medicaid State Provider ID
117899803 (TX)
Commercial Insurance / Payer ID Amerigroup
10013121 (TX)
Commercial Insurance / Payer ID First Care
146573100
Commercial Insurance / Payer ID Davis Vision
32787-013 (NY)
Commercial Insurance / Payer ID Bluelink
8114413 (TX)
Commercial Insurance / Payer ID Aetna
4511497 (TX)
Commercial Insurance / Payer ID Blue Cross Blue Shield
88Y393 (TX)
Commercial Insurance / Payer ID Block Vision
911390 (TX)
Commercial Insurance / Payer ID Eyemed
TX2442 (OH)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1124004189

Doctor of Optometry

NPI 1942286448

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 01, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location February 01, 2010

Registered at 85 LOOP 150 W, BASTROP, TX 786023930 (Tel: 5123037300)

📍
Updated Business Mailing Address February 01, 2010

Registered at 5717 BALCONES DR, AUSTIN, TX 787314203 (Tel: 5123277000)

👤
Provider Name / Credentials Updated February 01, 2010

Recorded as MARK LICATINO, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 01, 2010

Optometrist (License #2442TG in TX)

🟢
Initial NPI Registration & Enumeration December 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083690051
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 21, 2005
Last Update: February 01, 2010
Sole Proprietor: No

Mailing Address

5717 Balcones Dr

Austin, TX 787314203

Phone: 5123277000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.