Basic Information
| Provider Information | |||||||||
| NPI: | 1215234208 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOUAY K. SABIH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10550 MARTY ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662122557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133414000 | ||||||||
| FaxNumber: | 9133832868 | ||||||||
| Practice Location | |||||||||
| Address1: | 10550 MARTY ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133414000 | ||||||||
| FaxNumber: | 9133832868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2011 | ||||||||
| LastUpdateDate: | 06/08/2018 | ||||||||
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| AuthorizedOfficialLastName: | RAOOF | ||||||||
| AuthorizedOfficialFirstName: | AHMED | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9133414000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0427401 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1215234208 | 05 | MO | MEDICAID | DT1379 | 01 | KS | MDCR RR | OTHER |