Provider Demographics
NPI:1952764268
Name:MUKKU, VENKATA KISHORE REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATA KISHORE
Middle Name:REDDY
Last Name:MUKKU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5741 LIGHTFOOT LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-1112
Mailing Address - Country:US
Mailing Address - Phone:409-543-2001
Mailing Address - Fax:
Practice Address - Street 1:1600 COIT RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6172
Practice Address - Country:US
Practice Address - Phone:972-295-9660
Practice Address - Fax:972-295-9660
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0749207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology