Provider Demographics
NPI:1134741556
Name:FORA FERTILITY, PLLC
Entity type:Organization
Organization Name:FORA FERTILITY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKILLERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-516-1594
Mailing Address - Street 1:715 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1223
Mailing Address - Country:US
Mailing Address - Phone:512-956-5006
Mailing Address - Fax:
Practice Address - Street 1:2200 PECOS ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-2124
Practice Address - Country:US
Practice Address - Phone:512-516-1594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty