Individual provider Active NPI

Kim Minh Ngoc Le, DO

  • Gastroenterology Physician
  • Fort Worth, TX
National Provider Identifier
1104385970
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
V6623 Issued in TX
Practice address
9509 N Beach St Ste 101
Fort Worth, TX 76244-6399
Phone
(817) 741-4347
Fax
(817) 741-4483
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X V6623 TX Primary

Addresses

Primary practice location

9509 N Beach St Ste 101
Fort Worth, TX 76244-6399

Mailing address

950 E State Highway 114 Ste 200
Southlake, TX 76092-5261
Phone (214) 424-2200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250821004921 TX Practitioner - Gastroenterology 8729312954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of North Texas HSC, College of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

9509 N Beach St
Suite 101
Fort Worth, TX 76244-6399
Phone (817) 741-4347

Hospital & facility affiliations

  • Medical City Alliance Hospital, Fort Worth, TX, CCN 670103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Upper gastrointestinal (GI) endoscopy for acid reflux16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
V6623TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Aug 15, 2025 Accepting new patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Aug 15, 2025 Accepting new patients

Locations

9509 N Beach St
Ste 101
Fort Worth, TX 76244
Phone (817) 741-4347

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

950 E State Highway 114
Ste 200
Southlake, TX 76092

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1104385970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E STATE HIGHWAY 114 STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925261",
            "telephone_number": "214-424-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9509 N BEACH ST STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446399",
            "telephone_number": "817-741-4347",
            "fax_number": "817-741-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KIM MINH",
        "middle_name": "NGOC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-07-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "V6623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.