Provider Demographics
NPI:1275714313
Name:AHMAD, SYED OMAR (OTD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:OMAR
Last Name:AHMAD
Suffix:
Gender:M
Credentials:OTD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15103 W 84TH TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1809
Mailing Address - Country:US
Mailing Address - Phone:913-620-2150
Mailing Address - Fax:
Practice Address - Street 1:6700 ANTIOCH RD STE 430
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1258
Practice Address - Country:US
Practice Address - Phone:913-652-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist