Healthcare Provider Details

I. General information

NPI: 1689742637
Provider Name (Legal Business Name): AISHA MIRZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 FAIRMONT PKWY
PASADENA TX
77504-3013
US

IV. Provider business mailing address

6701 FANNIN ST STE 1540
HOUSTON TX
77030-2613
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-6306
  • Fax:
Mailing address:
  • Phone: 832-822-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS9036
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-105960
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: