Provider Demographics
NPI:1063750719
Name:SRIANANT, TAMRA DEE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TAMRA
Middle Name:DEE
Last Name:SRIANANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:TAMRA
Other - Middle Name:DEE
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5301 S YOSEMITE ST APT 35-103
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3340
Mailing Address - Country:US
Mailing Address - Phone:512-376-0100
Mailing Address - Fax:
Practice Address - Street 1:4101 KIRKPATRICK LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1415
Practice Address - Country:US
Practice Address - Phone:214-513-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11425363A00000X
CA22804363A00000X
COPA.0006513363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant