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General NPI Number Information
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NPI Number | 1215808340
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Entity Type | Individual
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Provider Name | MARYAM BASEM BALDAWI DDS
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Gender | Female
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 14611 WALLISVILLE RD # 100
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City | HOUSTON
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State | TX
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Zip | 77049-4435
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Country | US
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Telephone | 281-845-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 JOHANNA DR
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City | HOUSTON
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State | TX
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Zip | 77055-5022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41990
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License Number State | TX
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