Provider Demographics
NPI:1902913064
Name:HAMID, BASSAM AHMAD (MD)
Entity type:Individual
Prefix:MR
First Name:BASSAM
Middle Name:AHMAD
Last Name:HAMID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1905
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-1905
Mailing Address - Country:US
Mailing Address - Phone:281-427-2149
Mailing Address - Fax:281-427-4390
Practice Address - Street 1:2802 GARTH RD STE 203
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3924
Practice Address - Country:US
Practice Address - Phone:281-427-2149
Practice Address - Fax:281-427-4390
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8261207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136448106Medicaid
TX136448108Medicaid
TX87Z400Medicare ID - Type Unspecified
TX136448108Medicaid