Provider Demographics
NPI:1063860344
Name:IZZAT BECK, TAREQ (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:TAREQ
Middle Name:
Last Name:IZZAT BECK
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8406 HALL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4911
Mailing Address - Country:US
Mailing Address - Phone:832-791-3039
Mailing Address - Fax:
Practice Address - Street 1:8406 HALL RD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4911
Practice Address - Country:US
Practice Address - Phone:832-791-3039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415216122300000X
TX31885122300000X, 1223P0300X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics