Healthcare Provider Details

I. General information

NPI: 1114207370
Provider Name (Legal Business Name): ROLA A MAHMOUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 W 98TH TER STE 140
OVERLAND PARK KS
66212-6158
US

IV. Provider business mailing address

7111 W 98TH TER STE 140
OVERLAND PARK KS
66212-6158
US

V. Phone/Fax

Practice location:
  • Phone: 913-303-1019
  • Fax:
Mailing address:
  • Phone: 913-303-1019
  • Fax: 472-227-3071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number04-39288
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2016027117
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: