Individual
MALLIKARJUNA R. MUKKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
207R00000X
Internal Medicine Physician
L9822
TX
207RI0200X
Infectious Disease Physician
Primary
L9822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167966404
—
TX
Enumeration date
05/20/2006
Last updated
07/23/2025
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