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General NPI Number Information
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NPI Number | 1578898920
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Entity Type | Organization
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Legal Business Name | MUHAMMAD ALI MIRZA, MD, P.A.
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 4300 N JOSEY LN SUITE 110
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City | CARROLLTON
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State | TX
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Zip | 75010-4744
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Country | US
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Telephone | 214-483-3292
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Fax | 214-483-3286
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Provider Business Mailing Address
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Address Line | 4300 N JOSEY LN SUITE 110
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City | CARROLLTON
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State | TX
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Zip | 75010-4744
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Country | US
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Telephone | 214-483-3292
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Fax | 214-483-3286
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MUHAMMAD ALI MIRZA
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Credential | M.D.
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Telephone | 214-483-3292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J0404
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License Number State | TX
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