Basic Information
Provider Information
NPI: 1811304173
EntityType: 2
ReplacementNPI:  
OrganizationName: MIRZA BAIG MD PLLC
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Mailing Information
Address1: 9101 LBJ FREEWAY
Address2: STE 710
City: DALLAS
State: TX
PostalCode: 752431912
CountryCode: US
TelephoneNumber: 9727925700
FaxNumber: 2143497707
Practice Location
Address1: 9101 LBJ FREEWAY
Address2: STE 710
City: DALLAS
State: TX
PostalCode: 752431912
CountryCode: US
TelephoneNumber: 9727925700
FaxNumber: 2143497707
Other Information
ProviderEnumerationDate: 07/18/2014
LastUpdateDate: 07/18/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BAIG
AuthorizedOfficialFirstName: MIRZA
AuthorizedOfficialMiddleName: S
AuthorizedOfficialTitleorPosition: MD, PRESIDENT
AuthorizedOfficialTelephone: 9727925700
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X  N193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgery 
2086S0129X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery

ID Information
IDTypeStateIssuerDescription
102327552601TXNPIOTHER
P196101TXTEXAS MEDICAL LICENSEOTHER


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