Individual
DR. MICHAEL J. MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4708 ALLIANCE BLVD, SUITE 700, PAVILLION I, PLANO, TX 75093-5340
(972) 596-6676
(972) 596-7078
Mailing address
4708 ALLIANCE BLVD, SUITE 700, PAVILLION I, PLANO, TX 75093-5340
(972) 596-6676
(972) 596-7078
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
F6018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115911305
—
TX
Enumeration date
10/07/2005
Last updated
09/28/2012
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