Provider Demographics
NPI:1053833236
Name:CONSULT FORTITUDE, INC
Entity type:Organization
Organization Name:CONSULT FORTITUDE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-CHIROPRACTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-930-6468
Mailing Address - Street 1:951 FM 646 RD E STE A7
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-5597
Mailing Address - Country:US
Mailing Address - Phone:281-930-6468
Mailing Address - Fax:281-930-6468
Practice Address - Street 1:951 FM 646 RD E STE A7
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-5597
Practice Address - Country:US
Practice Address - Phone:281-930-6468
Practice Address - Fax:281-930-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13142111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty