Healthcare Provider Details

I. General information

NPI: 1114864964
Provider Name (Legal Business Name): SYEDA MIRAL BANO NAQVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22618 ALDINE WESTFIELD RD
SPRING TX
77373-6569
US

IV. Provider business mailing address

PO BOX 660682
DALLAS TX
75266-0682
US

V. Phone/Fax

Practice location:
  • Phone: 469-490-3709
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42582
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: