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General NPI Number Information
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NPI Number | 1558792218
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Entity Type | Organization
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Legal Business Name | TRIVEDI PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 2550 NORTH LOOP W 260-I
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City | HOUSTON
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State | TX
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Zip | 77092-8902
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Country | US
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Telephone | 281-451-8112
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Fax | 855-271-3371
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Provider Business Mailing Address
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Address Line | 3919 R V MAYFIELD DR
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City | HOUSTON
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State | TX
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Zip | 77088-5648
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Country | US
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Telephone | 281-931-1401
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Fax | 855-271-3371
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. SHILPA B TRIVEDI
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Credential | PSY. D.
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Telephone | 281-931-1401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 36163
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License Number State | TX
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