Lecroy Family Medicine PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

K2736 Issued in TX

Legal business name

LECROY FAMILY MEDICINE PA

Doing business as

Lighthouse Family Medicine

Practice address

6424 Colleyville Blvd Ste 104
Colleyville, TX 76034-6470

Phone

(817) 482-9422

Fax

(877) 738-7691

NPI assigned

Jul 3, 2007

Last updated

Mar 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Douglas Lecroy, MDNPI 1598848830

Title

Owner

Phone

(817) 482-9422

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Douglas Lecroy, M.D.

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1598848830
  Medicare reassignment NPD Authorized official
• Nicole Ann Howell, RN, FNP-C

  • Family Nurse Practitioner
  • Coppell, TX
  • NPI 1164571345
  NPD (past)
• Valerie Jones, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1629343314
  NPD (past)
• Tara Fulbright Lecroy, M.D.

  • Legal Medicine
  • Colleyville, TX
  • NPI 1023106812
  NPD (past)
• Amanda Renee Moore, D.C.

  • Chiropractor
  • Colleyville, TX
  • NPI 1063590990
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1851599690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 COLLEYVILLE BLVD STE 104",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346470",
            "telephone_number": "817-482-9422",
            "fax_number": "877-738-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 COLLEYVILLE BLVD STE 104",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346470",
            "telephone_number": "817-482-9422",
            "fax_number": "877-738-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LECROY FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "LECROY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-482-9422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "K2736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lighthouse Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Langenberg, OTR
• Anesha Lariez
• Laurel Lee Humphrey, M.D., PLLC
• David Lawson
• Melissa Lawver, LPC
• Kenneth Douglas Lecroy, M.D.
• Tara Fulbright Lecroy, M.D.
• Ronald Lee, DDS
• Song Young Lee, M.D.
• Lei Fu DDS LLC (Threestones Dentistry)

• Primary Care Clinic/Center in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.