Healthcare Provider Details

I. General information

NPI: 1205757655
Provider Name (Legal Business Name): MOHAMMAD QASIM OMARKHIL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18802 U ST
OMAHA NE
68135-4148
US

IV. Provider business mailing address

18802 U ST
OMAHA NE
68135-4148
US

V. Phone/Fax

Practice location:
  • Phone: 402-578-1802
  • Fax:
Mailing address:
  • Phone: 402-578-1802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: