Ahmed Mirza FNP-C, PLLC

Key facts

NPI

1669946380

Entity type

Organization (NPI type 2)

Primary specialty

Point of Service 305S00000X

Legal business name

AHMED MIRZA FNP-C, PLLC

Practice address

17913 Crimson Apple Way
Pflugerville, TX 78660-2423

Phone

(313) 485-4600

NPI assigned

Jan 15, 2019

Organization subpart

No

Authorized official

Name

Ahmed Ihsan Mirza, FNP-C

Title

Owner

Phone

(313) 485-4600

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2019.

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1669946380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17913 CRIMSON APPLE WAY",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602423",
            "telephone_number": "313-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17913 CRIMSON APPLE WAY",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602423",
            "telephone_number": "313-485-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHMED MIRZA FNP-C, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "IHSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-485-4600",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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