Kanwal Mirza, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

S3244 Issued in TX

Practice address

17510 W Grand Pkwy S Ste 460
Sugar Land, TX 77479-2173

Phone

(281) 766-4792

NPI assigned

Mar 24, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821
  Medicare reassignment NPD
• Ut Physicians

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD
• University of Texas Health Science Center at Houston

  • Psychiatric Hospital
  • Houston, TX
  • NPI 1578547667
  NPD (past)
• Tulane School Department of Psychiatry

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1063689966
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063874527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17510 W GRAND PKWY S STE 460",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792173",
            "telephone_number": "281-766-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17510 W GRAND PKWY S STE 460",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792173",
            "telephone_number": "281-766-4792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 W Baker Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Baytown",
            "state": "TX",
            "postal_code": "775212279",
            "country_code": "US",
            "telephone_number": "713-249-6802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "KANWAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2023-03-07",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "S3244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Brooke Minks, FNP
• Mint Physician Staffing
• Miracle EMS Inc
• Miracle Hands Healthcare Services
• Nicole Mirra, FNP
• Kiran Mishra, PH.D.
• Patricia Mitchell, MD
• Hari Shankar Mitra, M.D.
• MK & B Groups Inc
• MNM 1997, Inc

• Child & Adolescent Psychiatry Physician in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.