Provider Demographics
NPI:1821984790
Name:FORT, TAMARA (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:FORT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 WILD PECAN LOOP
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2577
Mailing Address - Country:US
Mailing Address - Phone:512-680-2287
Mailing Address - Fax:
Practice Address - Street 1:8911 N CAPITAL OF TEXAS HWY STE 1110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7203
Practice Address - Country:US
Practice Address - Phone:877-279-5960
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily