Disotell, Robert Ryan

Disotell, Robert Ryan is an individual health care provider with primary practice located at 2604 Saint Michael Dr Ste 340 , Texarkana TX 75503-2378. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Disotell, Robert Ryan can be contacted via phone (903) 614-5117.

Contact Information

Primary practice address
2604 Saint Michael Dr Ste 340 Texarkana TX 75503-2378
Phone: (903) 614-5117
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X A03684 Arkansas

Profile Details

NPI number 1265798805
LBN Legal business name Disotell, Robert Ryan
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2012
Last updated Apr 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265798805 NPPES
Arkansas Other A03684 LICENSE
Arkansas Other 1994 LICENSE

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