| Mallikarjuna Mukka Md Pa | |
|
6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 | |
| (817) 624-3500 | |
| (682) 708-7225 |
| Full Name | Mallikarjuna Mukka Md Pa |
|---|---|
| Speciality | Preferred Provider Organization |
| Location | 6551 Harris Pkwy Ste 110, Fort Worth, Texas |
| Authorized Official Name and Position | Mallikarjuna R Mukka (OWNER) |
| Authorized Official Contact | 8176243500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mallikarjuna Mukka Md Pa 6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 Ph: (817) 624-3500 | Mallikarjuna Mukka Md Pa 6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 Ph: (817) 624-3500 |
| NPI Number | 1215116660 |
|---|---|
| Provider Enumeration Date | 11/01/2007 |
| Last Update Date | 01/17/2020 |
| Medicare PECOS PAC ID | 9436222510 |
|---|---|
| Medicare Enrollment ID | O20080723000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215116660 | NPI | - | NPPES |
| 208321401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
| 305R00000X | Preferred Provider Organization | L9822 (Texas) | Primary |
| Provider Name | Mallikarjuna R Mukka |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487608923 PECOS PAC ID: 2466413018 Enrollment ID: I20041026000871 |
| Provider Name | Geeta Manthena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326257163 PECOS PAC ID: 1951496678 Enrollment ID: I20101123000901 |
| Provider Name | Deepthi Bibinagar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982013439 PECOS PAC ID: 4789917113 Enrollment ID: I20190617003013 |
| Provider Name | Uzoma Ifeyinwa Ezeuka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689122574 PECOS PAC ID: 2163790882 Enrollment ID: I20200319000122 |
| Provider Name | Kristen Latonya Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902479983 PECOS PAC ID: 4880099837 Enrollment ID: I20210830000951 |
| Provider Name | Vismay Badhiwala |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134617830 PECOS PAC ID: 3173932043 Enrollment ID: I20230822001331 |
Southwest Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 Bryant Irvin Rd, Suite 203, Fort Worth, TX 76132 Phone: 817-346-4000 Fax: 817-263-9398 | |
University Of North Texas Health Science Center At Fort Worth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 855 Montgomery St, Fort Worth, TX 76107 Phone: 817-735-2000 | |
Hanson Internal Medicine, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6100 Harris Pkwy, Suite 240, Fort Worth, TX 76132 Phone: 817-504-5699 | |
Feliz Family Medical Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3109 6th Ave, Fort Worth, TX 76110 Phone: 817-923-7055 Fax: 817-923-7902 | |
Symetria Health Of Texas, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7229 Hawkins View Dr, Fort Worth, TX 76132 Phone: 682-350-4444 | |
Associates Of Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2260 College Ave, Fort Worth, TX 76110 Phone: 682-268-1152 Fax: 877-772-0063 | |
Apex Alliance Medical Group Lp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2401 Westport Pkwy, Suite 150, Fort Worth, TX 76177 Phone: 817-837-1091 Fax: 817-837-1097 |