Provider Demographics
NPI:1700956141
Name:FORBES, CARYN MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:MICHELLE
Last Name:FORBES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2429
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-8429
Mailing Address - Country:US
Mailing Address - Phone:972-420-1475
Mailing Address - Fax:469-671-5437
Practice Address - Street 1:2560 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 195
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1554
Practice Address - Country:US
Practice Address - Phone:972-420-1475
Practice Address - Fax:469-671-5437
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL3646208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160781401Medicaid
TX160781401Medicaid
TX8B14524Medicare PIN