Individual provider · Type 1 NPI

Lisa Rene Deshotel, PA-C

Medical Physician Assistant · Lafayette, LA

NPI number 1750413225 Active

Practice location

1602 W Pinhook Rd, Suite 100
Lafayette, LA 70508-3735

Call (337) 234-9925 Map

Fax (337) 237-5211

Mailing address

102 Isaiah Dr, Lafayette, La
Lafayette, LA 70508-5392

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA.A 10431RX (LA)

Medical Physician Assistant: Definition to come...

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About NPI 1750413225

Lisa Rene Deshotel, PA-C's National Provider Identifier is 1750413225, issued on Mar 11, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Lafayette, LA. The record was last updated on Jul 8, 2007.