Individual provider Active NPI

Arif K. Mirza, MD

  • Child & Adolescent Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1669591012
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
45393 Issued in TN
Practice address
1910 Pacific Ave Ste 2000
Dallas, TX 75201-4540
Phone
(469) 619-3553
Fax
(469) 277-3370
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 45393 TN Primary
Child & Adolescent Psychiatry Physician 2084P0804X 38057 OK
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X T2221 TX
Child & Adolescent Psychiatry Physician 2084P0804X E-5728 AR
Child & Adolescent Psychiatry Physician 2084P0804X 28707 MS

Addresses

Primary practice location

1910 Pacific Ave Ste 2000
Dallas, TX 75201-4540

Mailing address

1910 Pacific Ave Ste 2000
Dallas, TX 75201-4540
Phone (469) 619-3553

Other practice location 1

7505 Capital Dr
Germantown, TN 38138-3848
Phone (901) 730-0575

Other practice location 2

6608 N Western Ave Ste 1323
Oklahoma City, OK 73116-7326
Phone (405) 493-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-5728ARMDChild & Adolescent Psychiatry Physician
28707MSMDChild & Adolescent Psychiatry Physician
38057OKMDChild & Adolescent Psychiatry Physician
T2221TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Germantown Private Psychiatry PLLC Single Specialty Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6144/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1669591012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE STE 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014540",
            "telephone_number": "469-619-3553",
            "fax_number": "469-277-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE STE 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014540",
            "telephone_number": "469-619-3553",
            "fax_number": "469-277-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7505 Capital Dr",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383848",
            "country_code": "US",
            "telephone_number": "901-730-0575",
            "fax_number": "901-730-0389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6608 N Western Ave Ste 1323",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731167326",
            "country_code": "US",
            "telephone_number": "405-493-6790",
            "fax_number": "405-265-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "ARIF",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "45393",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OK",
            "license": "38057",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "T2221",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AR",
            "license": "E-5728",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "28707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.