Healthcare Provider Details

I. General information

NPI: 1710905393
Provider Name (Legal Business Name): TODD TRASK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST SCURLOCK TOWER, SUITE 900
HOUSTON TX
77030-2761
US

IV. Provider business mailing address

6560 FANNIN ST SCURLOCK TOWER, SUITE 900
HOUSTON TX
77030-2761
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-3800
  • Fax: 713-793-1015
Mailing address:
  • Phone: 713-441-3800
  • Fax: 713-793-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberK0221
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: