Active NPI
Arif K. Mirza, MD
- Child & Adolescent Psychiatry Physician
- Dallas, TX
National Provider Identifier
1669591012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 45393
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 45393 | TN | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 38057 | OK | |
| Child & Adolescent Psychiatry Physician | 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
| License | State | Type | Specialty |
|---|---|---|---|
| E-5728 | AR | MD | Child & Adolescent Psychiatry Physician |
| 28707 | MS | MD | Child & Adolescent Psychiatry Physician |
| 38057 | OK | MD | Child & Adolescent Psychiatry Physician |
| T2221 | TX | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Germantown Private Psychiatry PLLC | Single Specialty | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Child & Adolescent Psychiatry Physician
- Germantown, TN
- NPI 1467799767
Single Specialty
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.