Provider Demographics
NPI:1194819326
Name:ZAMORA, BELISSA (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:BELISSA
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:BELISSA
Other - Middle Name:
Other - Last Name:ZAMORA-MARROQUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3000 N. IH-35, SUITE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1804
Mailing Address - Country:US
Mailing Address - Phone:512-807-3150
Mailing Address - Fax:512-458-7879
Practice Address - Street 1:3000 N. IH-35, SUITE 700
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1804
Practice Address - Country:US
Practice Address - Phone:512-807-3150
Practice Address - Fax:512-458-7879
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX563414363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175720501Medicaid
TXS95887Medicare UPIN
TX8A5692Medicare PIN
TX8A2898Medicare PIN