Healthcare Provider Details

I. General information

NPI: 1023739760
Provider Name (Legal Business Name): MIRZA BAIG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6429 FAIRMONT PKWY STE 102
PASADENA TX
77505-4357
US

IV. Provider business mailing address

10755 OCELOT LN
HOUSTON TX
77034-2197
US

V. Phone/Fax

Practice location:
  • Phone: 281-299-0053
  • Fax:
Mailing address:
  • Phone: 661-755-2786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42282
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: