Individual
MS. JIMMIE LEE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1441 N BECKLEY AVE, METHODIST DALLAS MEDICAL CENTER, PECA, DALLAS, TX 75203-1201
(214) 942-5733
Mailing address
8702 LAKEPOINTE AVE, ROWLETT, TX 75088-6863
(972) 412-8286
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01380
TX
Other
Enumeration date
04/25/2007
Last updated
02/11/2011
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