Kenneth Douglas Lecroy, M.D.
Individual provider Active NPI Family Medicine Physician · Colleyville, TX
NPI 1598848830 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1598848830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- K2736 (TX)
- Practice address
- 6515 Colleyville Blvd
Colleyville, TX 76034-6231 - Phone
- (817) 424-3774
- Fax
- (817) 424-3398
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Medical School at San Antonio, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6424 Colleyville Blvd
Suite 104
Colleyville, TX 76034-6470
Phone (817) 482-9422
Hospital & facility affiliations
- Baylor Scott & White Medical Center Grapevine
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120629000381 | TX | Practitioner - Family Practice | 1658547344 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Medical Services PLLC | Current | Accepting new patients | |
| Lecroy Family Medicine PA | Family Medicine | Current |
Accepting new patients |
| Kallal Bros, LLC | Past |
Accepting new patients |
Locations
6630 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 424-3774
6424 Colleyville Blvd
Ste 104
Colleyville, TX 76034
Phone (817) 482-9422
6515 Colleyville Blvd
Colleyville, TX 76034
Phone (682) 593-7639
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JEGFBD/Endpoint/JEGFBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K2736 | TX | Yes |
Addresses
Primary practice location
6515 Colleyville Blvd
Colleyville, TX 76034-6231
Mailing address
6424 Colleyville Blvd Ste 104
Colleyville, TX 76034-6470
Phone (817) 482-9422
Other providers in Colleyville, TX
- Anesha Lariez
- Laurel Lee Humphrey, M.D., PLLC
- David Lawson
- Melissa Lawver
- Lecroy Family Medicine PA
- Tara Fulbright Lecroy
- Ronald Lee
- Song Young Lee
- Lei Fu DDS LLC
- Jonathan Leisten
All providers in Colleyville, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.