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Individual

JACK MA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1504 TAUB LOOP FL 18, HOUSTON, TX 77030-1608
(713) 873-8890
(713) 795-7070
Mailing address
1504 TAUB LOOP FL 18, HOUSTON, TX 77030-1608
(713) 795-7070

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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