MEDICARE: TALAL BASSAM BEIDAS DDS

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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	41309	TX

General Provider Information

NPI Number	:	1285215939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALAL BASSAM BEIDAS DDS

Provider Business Mailing Address
First Line	:	2450 FONDREN RD STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2320
Country	:	US
Telephone Number	:	713-783-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 FONDREN RD STE 320
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2320
Country	:	US
Telephone Number	:	713-783-5560
Fax Number	:

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

Provider Enumeration Date	:	04/15/2021
Last Update Date	:	06/27/2025

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Directions to “ TALAL BASSAM BEIDAS DDS” Practice Location

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