Individual provider Active NPI

Tu Cam Bui Forkner

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1396214052
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3804 W 15TH St Ste 140
Plano, TX 75075
Phone
(469) 326-1600
NPI assigned
Nov 24, 2018
Last updated
Jul 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3804 W 15TH St Ste 140
Plano, TX 75075

Mailing address

3804 W 15TH St Ste 140
Plano, TX 75075-7713
Phone (469) 326-1600

Other practice location 1

3804 W 15th St Ste 140
Plano, TX 75075
Phone (469) 326-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221219002403 TX Practitioner - Physician Assistant 1052780772 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Dec 6, 2022 Accepting new patients
Texas Health Physicians Group CurrentSince Dec 6, 2022 Accepting new patients
Specialized Womens Healthcare PLLC PastSince Feb 27, 2011 Accepting new patients
Melinda D Spooner MD PA Past Accepting new patients

Locations

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

6300 W Parker Rd
Ste 126
Plano, TX 75093
Phone (972) 526-0700

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1396214052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 W 15TH ST STE 140",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757713",
            "telephone_number": "469-326-1600",
            "fax_number": "469-326-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 W 15TH ST STE 140",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75075",
            "telephone_number": "469-326-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3804 W 15th St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "75075",
            "country_code": "US",
            "telephone_number": "469-326-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORKNER",
        "first_name": "TU",
        "middle_name": "CAM BUI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-24",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.