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LECROY FAMILY MEDICINE PA NPI 1851599690


NPI Information

NPI: 1851599690
Provider Name: LECROY FAMILY MEDICINE PA

Doing Business As: LIGHTHOUSE FAMILY MEDICINE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D0979488

Address:
6515 COLLEYVILLE BLVD
COLLEYVILLE, TX
ZIP 76034
Phone: (817) 424-3774
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LECROY FAMILY MEDICINE PA is a primary care clinic center in Colleyville, TX. LECROY FAMILY MEDICINE PA NPI is 1851599690. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lighthouse Family Medicine.

The provider's business location address is:

6515 COLLEYVILLE BLVD
COLLEYVILLE, TX
ZIP 76034-231
Phone: (817) 424-3774
Fax: (817) 424-3398

The provider's authorized official is Kenneth Douglas Lecroy .
The authorized official title is Owner and has the following contact phone number (817) 424-3774.

The CLIA number assigned to this NPI record is 45D0979488 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/3/2007 and was last updated on 10/8/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineTEXASNo
2261QP2300XClinic/CenterPrimary CareK2736TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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