Individual provider · Type 1 NPI

Mary K. Kukolich, MD

Clinical Genetics (M.D.) Physician · Fort Worth, TX

NPI number 1912918111 Active

Practice location

750 8th Ave Ste 200
Fort Worth, TX 76104-2500

Fax (817) 335-8277

Mailing address

PO Box 733784
Dallas, TX 75373-3784

Specialties and licenses

TaxonomyCodeLicense
Pediatrics Physician 208000000XE5817 (TX)
Clinical Genetics (M.D.) Physician Primary 207SG0201XE5817 (TX)

Clinical Genetics (M.D.) Physician: A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.

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About NPI 1912918111

Mary K. Kukolich, MD's National Provider Identifier is 1912918111, issued on Aug 11, 2006. The primary taxonomy on file is Clinical Genetics (M.D.) Physician (207SG0201X), and the practice location is in Fort Worth, TX. The record was last updated on May 17, 2021.