Provider Demographics
NPI:1558792218
Name:TRIVEDI PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:TRIVEDI PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILPA
Authorized Official - Middle Name:B
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:281-931-1401
Mailing Address - Street 1:3919 R V MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-5648
Mailing Address - Country:US
Mailing Address - Phone:281-931-1401
Mailing Address - Fax:855-271-3371
Practice Address - Street 1:2550 NORTH LOOP W
Practice Address - Street 2:260-I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8902
Practice Address - Country:US
Practice Address - Phone:281-451-8112
Practice Address - Fax:855-271-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36163103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty