SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION
Ambulatory Health at Mabel St, Shreveport, LA

License number
Louisiana 50
Category
Ambulatory Health
Type
Endoscopy
Owner
Name: DR. SATHYA JAGANMOHAN M.D.
Title: PRESIDENT
Phone: (318) 631-0072
Address
Address
3217 Mabel St, Shreveport, LA 71103
National Provider ID: 1982676771
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION

Shreveport, LA

Registration:
Nov 19, 1990
Addresses:
3217 Mabel St, Shreveport, LA 71103 (Physical)
3217 Mabel, Shreveport, LA 71103 (Mailing)
State ID:
34367919D
Business type:
Business Corporation
Officers:
Arthur L. Poch, M.d (Officer), 3217 Mabel, Shreveport, LA 71103 (Physical),David M. Philips, M.d (Officer), 3217 Mabel, Shreveport, LA 71103 (Physical),J. Mark Provenza, M.d (Officer), 3217 Mabel, Shreveport, LA 71103 (Physical),...
Agent:
Robert G. Pugh,333 Texas St, Shreveport, LA 71101 (Physical)

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