Individual provider · Type 1 NPI

Samuel Andrew Mack, MD

Student in an Organized Health Care Education/Training Program · Tyler, TX

NPI number 1902646094 Active

Practice location

1000 S Beckham Ave
Tyler, TX 75701-1908

Call (903) 597-0351 Map

Mailing address

2740 Royal Village Way
Tyler, TX 75701-5857

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1902646094

Samuel Andrew Mack, MD's National Provider Identifier is 1902646094, issued on May 28, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tyler, TX. The record was last updated on May 28, 2024.