MEDICARE: DR. SHILPA B. TRIVEDI PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	36163	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	TXB165656	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588774012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHILPA B. TRIVEDI PSY.D.

Provider Business Mailing Address
First Line	:	3919 R V MAYFIELD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77088-5648
Country	:	US
Telephone Number	:	281-451-8112
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 NORTH LOOP W STE 616
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2278
Country	:	US
Telephone Number	:	281-451-8112
Fax Number	:	855-271-3371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/12/2020

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