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Individual

LEO W MACK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5791 NEW COPELAND RD, TYLER, TX 75703-3905
(903) 630-7007
(903) 630-7072
Mailing address
5791 NEW COPELAND RD, TYLER, TX 75703-3905
(903) 630-7007
(903) 630-7072

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E4001
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
135428409
TX
Enumeration date
01/30/2006
Last updated
12/09/2025
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