Healthcare Provider Details

I. General information

NPI: 1477934313
Provider Name (Legal Business Name): BASSAM NAJEEB H ALBASSAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

6431 FANNIN ST STE MSB 3228
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-6511
  • Fax:
Mailing address:
  • Phone: 713-500-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberR7643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: