Healthcare Provider Details

I. General information

NPI: 1710946405
Provider Name (Legal Business Name): AYESHA MIRZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 W MICHAELANGELO DR
EDINBURG TX
78539-1402
US

IV. Provider business mailing address

1120 E RIDGE RD
MCALLEN TX
78503-5490
US

V. Phone/Fax

Practice location:
  • Phone: 956-558-6400
  • Fax:
Mailing address:
  • Phone: 956-688-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM0494
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberM0494
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: