| NPI | 1366619611 |
|---|---|
| Former Legal Business Name | LEO W MACK JR MD PA |
| Entity Type | Organization |
| Authorized Contact | SHARI LYNN WILLIAMS Administrator 903-630-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 007870) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2022-05-25 |