Provider Demographics
NPI:1174835979
Name:HARDESTY, PATTI SHAWN (CNS)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:SHAWN
Last Name:HARDESTY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 GUHN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6161
Mailing Address - Country:US
Mailing Address - Phone:713-783-8889
Mailing Address - Fax:713-953-0471
Practice Address - Street 1:5500 GUHN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6161
Practice Address - Country:US
Practice Address - Phone:713-783-8889
Practice Address - Fax:713-953-0471
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX504702364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult