NPIMap

Individual provider Active NPI

Son Minh Le, PA

  • Physician Assistant
  • Amarillo, TX
National Provider Identifier
1174655054
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05164 Issued in TX
Practice address
705 Quail Creek Dr
Amarillo, TX 79124-1608
Phone
(806) 353-6400
NPI assigned
Mar 9, 2007
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 PA05164 TX Primary

Addresses

Primary practice location

705 Quail Creek Dr
Amarillo, TX 79124-1608

Mailing address

705 Quail Creek Dr
Amarillo, TX 79124-1608
Phone (806) 353-6400

Other practice location 1

6822 Plum Creek Dr
Amarillo, TX 79124-1601
Phone (806) 373-3177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070702000429 TX Practitioner - Physician Assistant 2567562655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Neuroscience and Spine Center PAGroup PAC ID 0345133823, 11 clinicians

Practice addresses (Care Compare)

1600 S Coulter St
Suite B
Amarillo, TX 79106-0703
Phone (806) 354-2429

705 Quail Creek Dr
Amarillo, TX 79124-1608
Phone (806) 353-6400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Well Life Family Medicine, P.a. PastSince Jan 14, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: son.le@direct.myteamcare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1174655054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 QUAIL CREEK DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791241608",
            "telephone_number": "806-353-6400",
            "fax_number": "806-353-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 QUAIL CREEK DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791241608",
            "telephone_number": "806-353-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6822 Plum Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791241601",
            "country_code": "US",
            "telephone_number": "806-373-3177",
            "fax_number": "806-373-0423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "SON",
        "middle_name": "MINH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.