Leo W Mack Jr MD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

007870 Issued in TX

Legal business name

LEO W MACK JR MD PA

Practice address

5791 New Copeland Rd
Tyler, TX 75703-3905

Phone

(903) 630-7007

Fax

(903) 630-7072

NPI assigned

May 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shari Lynn Williams

Title

Administrator

Phone

(903) 630-7007

Specialties & licenses 1

Addresses

Other names 1

• Leo W Mack Jr MD PA Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leo W Mack Jr., M.D.

  • Ophthalmology Physician
  • Tyler, TX
  • NPI 1669443370
  Medicare reassignment NPD
• Seth Lyle Goolsbee, OD

  • Optometrist
  • Tyler, TX
  • NPI 1174015523
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765238400000",
    "number": "1366619611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5791 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-630-7007",
            "fax_number": "903-630-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5791 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033905",
            "telephone_number": "903-630-7007",
            "fax_number": "903-630-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO W MACK JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-630-7007",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "007870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leo W Mack Jr MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Leo W Mack Jr MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ashley Nicole Lemon
• Erick R. Lenert, PH.D.
• Jordan Spencer Lenox, DC
• Antoinette Lenton, M.D.
• Sachi M Lentz
• Foster Scott Lerner, DO
• Tiffany Leshore
• Ashley Lesniewski
• Neisha Lestage
• Lester B Collins III MD PC

• Optometrist in Tyler, TX
• Providers in Tyler, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.