Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | A79653 | CA |
Y | 2086S0129X | Vascular Surgeon | P1961 | TX |
NPI | 1023275526 |
---|---|
Provider Name | Dr. Mirza Shadman Baig |
First Address | Dallas, TX 75390-0001 |
Second Address | Dallas, TX 75390-7539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 19/01/2021 |