MALLIKARJUNA MUKKA MD PA (NPI# 1215116660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215116660 |
| Entity Type | Organization |
| Organization Name | MALLIKARJUNA MUKKA MD PA |
| Practice Address |
6551 Harris Pkwy Ste 110 Fort Worth TX 76132-6105 |
| Practice Telephone | 8176243500 |
| Practice Fax Number | 6827087225 |
| Mailing Telephone | 8176243500 |
| Mailing Fax Number | 8175275305 |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2020-01-17 |
| Authorized Official Name | DR. MALLIKARJUNA R MUKKA (OWNER) |
| Authorized Official Telephone | 8176243500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 305R00000X | Preferred Provider Organization | L9822 | TX | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 208321401 | 05 |
| Street Address |
6551 HARRIS PKWY STE 110 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76132-6105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356319990 | Madhukanth T. Reddy | Internal Medicine | 6551 Harris Pkwy Ste 110, Fort Worth, TX 76132 | 2006-03-09 |
| 1457982126 | Ancy Mathew | Nurse Practitioner | 6551 Harris Pkwy Ste 110, Fort Worth, TX 76132-6105 | 2020-01-30 |
| 1205487717 | Infectious Diseases Consultants of Texas Pllc | Internal Medicine | 6551 Harris Pkwy Ste 110, Fort Worth, TX 76132-6105 | 2019-09-25 |
| 1487608923 | Mallikarjuna R. Mukka | Internal Medicine | 6551 Harris Pkwy Ste 110, Fort Worth, TX 76132-6105 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1306112149 | Dental Boat Club P.c | Preferred Provider Organization | 4625 Boat Club Rd, Ste 225, Fort Worth, TX 76135-7022 | 2012-03-27 |
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| 1962931220 | Ai Community Services LLC | Preferred Provider Organization | 6928 Shoreway Dr, Grand Prairie, TX 75054 | 2017-06-08 |
| 1649706227 | Divine Integrity Allied Healthcare Services | Preferred Provider Organization | 4738 Bedford Ave, Midland, TX 79703-4535 | 2017-05-03 |
| 1255866950 | Guardian of Angels Community Living | Preferred Provider Organization | 12703 Jones Rd, 1115, Houston, TX 77070-4676 | 2017-05-01 |
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| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.