PROMAS LLC (NPI# 1770809238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770809238 |
| Entity Type | Organization |
| Organization Name | PROMAS LLC |
| Practice Address |
1453 E Bert Kouns Industrial Loop Shreveport LA 71105 |
| Mailing Address |
Po Box 52078 Shreveport LA 71135-2078 |
| Practice Telephone | 3186814126 |
| Mailing Telephone | 8008289227 |
| Mailing Fax Number | 3188614724 |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2018-07-09 |
| Authorized Official Name | DR. ROSCOE HO-KEUNG CHAN (OWNER) |
| Authorized Official Telephone | 3186814126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
014269R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 183754002 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Saint Mary Pl, Shreveport, LA 711014343 | 3186814500 |
| Street Address |
1453 E BERT KOUNS INDUSTRIAL LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417950106 | Christus Health Northern Louisiana | General Acute Care Hospital | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2005-05-27 |
| 1508402546 | Christus Health Northern Louisiana | Clinic/Center | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2019-11-25 |
| 1528610052 | Danielle Bowlin | Radiologic Technologist | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2019-07-15 |
| 1447818414 | Susan Diaz Merry | Nurse Practitioner | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2019-06-04 |
| 1053899542 | Hospitalist Medicine Physicians of Louisiana-tcg, Inc. | Internal Medicine | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2018-08-06 |
| 1508369562 | Malini Chintapalli, Do, Apmc | Physical Medicine & Rehabilitation | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2018-03-15 |
| 1508295536 | American Physicians, Inc | Family Medicine | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2013-11-12 |
| 1508118258 | Laurie Crnkovic Simmons | Nurse Practitioner | 1453 E Bert Kouns Industrial Loop, Suite 221, Shreveport, LA 71105-6800 | 2012-10-04 |
| 1265675193 | Amy Kathryn Gessford | Hospitalist | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2009-04-08 |
| 1194989244 | Laura Elizabeth Anissian | Internal Medicine | 1453 E Bert Kouns Industrial Loop, Ste 221, Shreveport, LA 71105-5634 | 2008-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669564258 | Radiation Oncology Services Apmc | Radiology | 2600 Kings Hwy., Shreveport, LA 71103 | 2006-09-29 |
| 1265439863 | Michael Leonard Durci | Radiology | 2600 Kings Hwy, Willis Knighton Cancer Center, Shreveport, LA 71103-3950 | 2005-06-28 |
| 1922478304 | Wk Radiation Oncology Services | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-09-29 |
| 1659767127 | Sergio Jaramillo | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-04-11 |
| 1457615395 | Chiachien Jake Wang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2012-06-26 |
| 1093006603 | Daniella Phuong-di Dang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2011-04-29 |
| 1225258809 | Radiation Oncology St Mary Place LLC | Radiology | One Saint Mary Place, Cancer Treatment Center, Shreveport, LA 71101-4343 | 2007-04-26 |
| 1548487804 | Radiation Oncology Associates A Medical Corporation | Radiology | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2007-04-19 |
| 1578576526 | Beng-hoey Jo | Radiology | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2006-08-14 |
| 1215943642 | Sanford Rory Katz | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2006-07-31 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.