1194781948 NPI number — SAID F MAHMOUD MD, FCCP

Table of content: SAID F MAHMOUD MD, FCCP (NPI 1194781948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194781948 NPI number — SAID F MAHMOUD MD, FCCP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHMOUD
Provider First Name:
SAID
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, FCCP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194781948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 844458
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0458
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-322-8859
Provider Business Mailing Address Fax Number:
888-778-9471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8701 TROOST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64131-2767
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-995-2114
Provider Business Practice Location Address Fax Number:
888-778-9471
Provider Enumeration Date:
04/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  R9594 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07989058 . This is a "BLUE SHIELD KC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 201015328 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100190430A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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