Provider Demographics
NPI:1285215939
Name:BEIDAS, TALAL BASSAM (DDS)
Entity type:Individual
Prefix:
First Name:TALAL
Middle Name:BASSAM
Last Name:BEIDAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 FONDREN RD STE 320
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2320
Mailing Address - Country:US
Mailing Address - Phone:713-783-5560
Mailing Address - Fax:
Practice Address - Street 1:2450 FONDREN RD STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2320
Practice Address - Country:US
Practice Address - Phone:713-783-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41309204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery