Provider Demographics
NPI:1477901999
Name:FORTITUDE CONSULTING GROUP INC
Entity Type:Organization
Organization Name:FORTITUDE CONSULTING GROUP INC
Other - Org Name:FORTITUDE CONSULTING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:713-677-1980
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77574-0709
Mailing Address - Country:US
Mailing Address - Phone:713-677-1980
Mailing Address - Fax:
Practice Address - Street 1:14019 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3563
Practice Address - Country:US
Practice Address - Phone:713-677-1980
Practice Address - Fax:281-491-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty