Kukolich, Mary K
Kukolich, Mary K is an individual health care provider with primary practice located at 750 8Th Ave Ste 200 , Fort Worth TX 76104-2500. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.). Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is her primary health care specialty. Kukolich, Mary K can be contacted via phone (682) 885-2170.Contact Information
Primary practice address
750 8Th Ave Ste 200
Fort Worth TX 76104-2500
Phone: (682) 885-2170
Fax: (817) 335-8277
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | E5817 | Texas |
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | E5817 | Texas |
Profile Details
| NPI number | 1912918111 |
|---|---|
| LBN Legal business name | Kukolich, Mary K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | May 17th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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