Mallikarjuna Mukka Md Pa
LBN: Mallikarjuna Mukka Md Pa
Mallikarjuna Mukka Md Pa is an health care organization with primary practice located at 6551 Harris Pkwy Ste 110 , Fort Worth TX 76132-6105. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Managed Care Organizations / Preferred Provider Organization. Managed Care Organizations / Preferred Provider Organization is the primary health care specialty.
Mallikarjuna Mukka Md Pa can be contacted via phone (817) 624-3500, or through Mukka, Mallikarjuna R via phone (817) 624-3500.
Contact Information
Primary practice address
6551 Harris Pkwy Ste 110
Fort Worth TX 76132-6105
Phone: (817) 624-3500
Fax: (682) 708-7225
Website:
Authorized official contact:
Name: Mukka, Mallikarjuna R Doctor of Medicine (MD)
Phone: (817) 624-3500
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | ||
| Managed Care Organizations / Preferred Provider Organization | 305R00000X | L9822 | Texas |
Profile Details
| NPI number | 1215116660 |
|---|---|
| LBN Legal business name | Mallikarjuna Mukka Md Pa |
| DBA Doing business as | |
| Authorized official | Mukka, Mallikarjuna R Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2007 |
| Last updated | Jan 17th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215116660 | NPPES |
| Texas | MEDICAID | 208321401 |
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