Healthcare Provider Details

I. General information

NPI: 1598693178
Provider Name (Legal Business Name): AHMED MALIK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11970 S BLACKBOB RD STE 100
OLATHE KS
66062-2023
US

IV. Provider business mailing address

15320 PERRY ST
OVERLAND PARK KS
66221-7504
US

V. Phone/Fax

Practice location:
  • Phone: 913-632-4770
  • Fax:
Mailing address:
  • Phone: 913-945-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: