Mack, James Andrew

Mack, James Andrew is an individual health care provider with primary practice located at 3004 Hg Mosley Pkwy , Longview TX 75605-2948. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mack, James Andrew can be contacted via phone (903) 758-3444.

Contact Information

Primary practice address
3004 Hg Mosley Pkwy Longview TX 75605-2948
Phone: (903) 758-3444
Fax: (903) 758-1967
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 14659 Texas

Profile Details

NPI number 1073606281
LBN Legal business name Mack, James Andrew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jun 14th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073606281 NPPES
Texas MEDICAID 130585604
Texas Other 89T822

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