Provider Demographics
NPI:1790896702
Name:DAVIS, PATTI MOSTELLER (MSW)
Entity Type:Individual
Prefix:MS
First Name:PATTI
Middle Name:MOSTELLER
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1431
Mailing Address - Country:US
Mailing Address - Phone:713-522-3329
Mailing Address - Fax:713-520-0423
Practice Address - Street 1:2439 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1431
Practice Address - Country:US
Practice Address - Phone:713-522-3329
Practice Address - Fax:713-520-0423
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical