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NPI Code Detail

MEDICARE: FORA FERTILITY, PLLC

MEDICARE: FORA FERTILITY, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VE0102XReproductive Endocrinology Physician

General Provider Information

NPI Number : 1134741556
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORA FERTILITY, PLLC
Provider Business Mailing Address
First Line : 715 W 34TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1223
Country : US
Telephone Number : 512-956-5006
Fax Number :
Provider Business Practice Location Address
First Line : 2200 PECOS ST
Second Line :
City : AUSTIN
State : TX
Zip : 78703-2124
Country : US
Telephone Number : 512-516-1594
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMANDA SKILLERN
Credential : MD
Telephone Number : 512-516-1594
Provider Enumeration Date : 05/07/2020
Last Update Date : 08/04/2020

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Directions to “FORA FERTILITY, PLLC ” Practice Location

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