MEDICARE: DR. TAREQ IZZAT BECK DDS,MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401415216	VA
2	122300000X	Dentist	31885	TX
3	1223P0300X	Periodontics	31885	TX
4	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	31885	TX

General Provider Information

NPI Number	:	1063860344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAREQ IZZAT BECK DDS,MS

Provider Business Mailing Address
First Line	:	8406 HALL RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77075-4911
Country	:	US
Telephone Number	:	832-791-3039
Fax Number	:

Provider Business Practice Location Address
First Line	:	8406 HALL RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77075-4911
Country	:	US
Telephone Number	:	832-791-3039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	09/20/2023

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