# MALLIKARJUNA MUKKA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215116660
- **Authorized official:** DR. MALLIKARJUNA R MUKKA MD (OWNER)
- **Authorized official phone:** (817) 624-3500

## Contact information

- **Practice address:** 6551 HARRIS PKWY STE 110, FORT WORTH, TX 76132-6105
- **Practice address phone:** (817) 624-3500
- **Practice address fax:** (682) 708-7225
- **Mailing address:** 6551 HARRIS PKWY STE 110, FORT WORTH, TX 76132-6105
- **Mailing address phone:** (817) 624-3500
- **Mailing address fax:** (682) 708-7225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |
| 305R00000X | Preferred Provider Organization | L9822 | TX | — |

## Other

- **Enumeration date:** 11/01/2007
- **Last updated:** 07/10/2025