Individual
MR. BISHAL BISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
315 W 15TH ST, LIBERAL, KS 67901-2455
(620) 629-6477
(620) 629-6651
Mailing address
315 W 15TH ST, LIBERAL, KS 67901-2455
(620) 629-6477
(620) 629-6651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005992
VA
363AM0700X
Medical Physician Assistant
Primary
1501810
KS
Other
Enumeration date
05/19/2016
Last updated
05/02/2023
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