Individual
MRS. LISA RENE DESHOTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1602 W PINHOOK RD, SUITE 100, LAFAYETTE, LA 70508-3735
(337) 234-9925
(337) 237-5211
Mailing address
102 ISAIAH DR, LAFAYETTE, LA, LAFAYETTE, LA 70508-5392
(337) 261-5232
(337) 237-5211
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.A 10431RX
LA
Other
Enumeration date
03/11/2007
Last updated
07/08/2007
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