Provider Demographics
NPI:1821273590
Name:MIR, OSMAN (MD)
Entity Type:Individual
Prefix:
First Name:OSMAN
Middle Name:
Last Name:MIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W MAYFIELD RD STE 407
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2085
Mailing Address - Country:US
Mailing Address - Phone:972-566-5412
Mailing Address - Fax:
Practice Address - Street 1:515 W MAYFIELD RD STE 407
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2085
Practice Address - Country:US
Practice Address - Phone:972-566-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN17742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0843286-01OtherGRP
TX2039547-01OtherTPI
TX1760488936OtherGRP NPI
TX2039547-02Medicaid
TX2039547-01OtherTPI