Healthcare Provider Details

I. General information

NPI: 1184132730
Provider Name (Legal Business Name): TRIVEDI FOOT AND ANKLE. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 WILLIAMS TRACE BLVD STE 108
SUGAR LAND TX
77478-4443
US

IV. Provider business mailing address

2205 WILLIAMS TRACE BLVD STE 108
SUGAR LAND TX
77478-4443
US

V. Phone/Fax

Practice location:
  • Phone: 713-614-2857
  • Fax:
Mailing address:
  • Phone: 713-614-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. KRUPA J TRIVEDI
Title or Position: OWNER
Credential: DPM
Phone: 281-529-5481