Provider Demographics
NPI:1770552416
Name:MUKKAMALA, APARNA (MD)
Entity type:Individual
Prefix:MRS
First Name:APARNA
Middle Name:
Last Name:MUKKAMALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 678397
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8397
Mailing Address - Country:US
Mailing Address - Phone:972-236-6800
Mailing Address - Fax:972-888-7079
Practice Address - Street 1:850 CENTRAL PKWY E STE 275
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5542
Practice Address - Country:US
Practice Address - Phone:972-881-4688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8137208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00368824Medicare PIN
I09312Medicare UPIN
TX8F3741Medicare PIN
TX8B9643Medicare ID - Type Unspecified