Individual
JACK MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
U3930
TX
2255A2300X
Athletic Trainer
U3930
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2019
Last updated
06/27/2023
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