Provider Demographics
NPI:1568766897
Name:TRIPATHI, SHIVANI S (MD)
Entity Type:Individual
Prefix:
First Name:SHIVANI
Middle Name:S
Last Name:TRIPATHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTMB PEDIATRICS
Mailing Address - Street 2:301 UNIVERSITY BLVD
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UTMB PEDIATRICS
Practice Address - Street 2:301 UNIVERSITY BLVD
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0351
Practice Address - Country:US
Practice Address - Phone:888-886-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105558208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics