Organization
PROMAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSCOE HO-KEUNG CHAN (OWNER)
(318) 681-4126
Entity
Organization
Contact information
Practice address
1453 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105
(318) 681-4126
Mailing address
PO BOX 52078, SHREVEPORT, LA 71135-2078
(800) 828-9227
(318) 861-4724
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
014269R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183754002
—
AR
Enumeration date
04/08/2010
Last updated
07/09/2018
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