Organization
MALLIKARJUNA MUKKA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALLIKARJUNA R MUKKA MD (OWNER)
(817) 624-3500
Entity
Organization
Contact information
Practice address
6551 HARRIS PKWY STE 110, FORT WORTH, TX 76132-6105
(817) 624-3500
(682) 708-7225
Mailing address
6551 HARRIS PKWY STE 110, FORT WORTH, TX 76132-6105
(817) 624-3500
(682) 708-7225
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
305R00000X
Preferred Provider Organization
L9822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208321401
—
TX
Enumeration date
11/01/2007
Last updated
07/10/2025
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