Healthcare Provider Details

I. General information

NPI: 1033050844
Provider Name (Legal Business Name): YASMIN MOHSEN TAHER RAGAB ALY MBBCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

714 S VALENTINE ST
LITTLE ROCK AR
72205-5757
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5162
  • Fax:
Mailing address:
  • Phone: 716-377-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: