Provider Demographics
NPI:1790527174
Name:FORTIS MED INCORPORATED
Entity type:Organization
Organization Name:FORTIS MED INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURUP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-239-1071
Mailing Address - Street 1:12417 BELLA VINO DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-4929
Mailing Address - Country:US
Mailing Address - Phone:817-239-1071
Mailing Address - Fax:817-782-9468
Practice Address - Street 1:12417 BELLA VINO DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76126-4929
Practice Address - Country:US
Practice Address - Phone:817-239-1071
Practice Address - Fax:817-782-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty