Provider Demographics
NPI:1417263518
Name:PATTERSON, SHAWN DELISLE (PHARM D, R PH)
Entity Type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:DELISLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PHARM D, R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 KINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3701
Mailing Address - Country:US
Mailing Address - Phone:281-360-4694
Mailing Address - Fax:281-360-2390
Practice Address - Street 1:4445 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3701
Practice Address - Country:US
Practice Address - Phone:281-360-4694
Practice Address - Fax:281-360-2390
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist