Provider Demographics
NPI:1669832366
Name:CATALYST CHIROPRACTIC
Entity Type:Organization
Organization Name:CATALYST CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-955-4013
Mailing Address - Street 1:1123 NEWHAVEN TRL
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7747
Mailing Address - Country:US
Mailing Address - Phone:972-955-4013
Mailing Address - Fax:
Practice Address - Street 1:1123 NEWHAVEN TRL
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7747
Practice Address - Country:US
Practice Address - Phone:972-955-4013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13142305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization