Lisa Rene Deshotel PA-C

NPI 1750413225 - Physician Assistant - 363AM0700X

NPI Details
NPI 1750413225
Gender Female
Enumeration Date 03/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1602 W PINHOOK RD
SUITE 100
LAFAYETTE LA, 70508-3735, US
Phone (337) 234-9925
Fax (337) 237-5211
Business Location
102 ISAIAH DR
LAFAYETTE, LA
LAFAYETTE LA, 70508-5392, US
Phone (337) 261-5232
Fax (337) 237-5211
Toxanomy
Taxonomy Code 363AM0700X
License State Louisiana
License Number PA.A 10431RX
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According to our database, Mrs. Lisa Rene Deshotel PA-C NPI is 1750413225, taxonomy code is 363AM0700X and license number is PA.A 10431RX, license state is located at Louisiana. Lisa Rene Deshotel PA-C physically located at 1602 W Pinhook Rd, Lafayette LA, 70508-3735. NPI Number Lisa Rene Deshotel PA-C has the Individual type.

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1750413225 NPI number is provided on an as is basis without warranty of any kind. 1750413225 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Rene Deshotel PA-C are for informational purposes only.