Individual
KETAN M TRIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 942-5733
(214) 942-6115
Mailing address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 942-5733
(214) 942-6115
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
044835
CT
207P00000X
Emergency Medicine Physician
Primary
M6430
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188491801
—
TX
05
—
188491802
—
TX
01
—
8AB540
BCBS
TX
01
—
8G4706
BCBS
TX
01
—
8J6424
MEDICARE
TX
01
—
P00425512
RR MEDICARE
TX
01
—
P00604902
RR MEDICARE
TX
Enumeration date
03/08/2007
Last updated
08/08/2008
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