Provider Demographics
NPI:1558495523
Name:HERBST, SHARON MARIE (MS)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:HERBST
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 ROYAL CREST DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2521
Mailing Address - Country:US
Mailing Address - Phone:281-488-4431
Mailing Address - Fax:281-488-1213
Practice Address - Street 1:16815 ROYAL CREST DR
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2521
Practice Address - Country:US
Practice Address - Phone:281-488-4431
Practice Address - Fax:281-488-1213
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85128LOtherBLUECROSSBLUESHIELD ID