DR. KIM A IGLESIA MD NPI 1689654097

NPI Information

NPI: 1689654097
Provider Name: DR. KIM A IGLESIA, MD
Classification: Radiology - 2085R0202X
Specialization: Diagnostic Radiology
Entity Type: Individual
PECOS Registration: Yes
Address: 815 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 321-0312

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NPI Details

DR. Kim A Iglesia, MD is a diagnostic radiology radiology in Fort Worth, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Kim A Iglesia, MD NPI is 1689654097. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

815 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104-224
Phone: (817) 321-0312
Fax: (817) 317-7033

The NPI 1689654097 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/20/2006 and was last updated on 8/15/2012.

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
1	2085B0100X	Radiology	Body Imaging	H6309	TEXAS	No
2	2085N0700X	Radiology	Neuroradiology	H6309	TEXAS	No
3	2085N0904X	Radiology	Nuclear Radiology	H6309	TEXAS	No
4	2085P0229X	Radiology	Pediatric Radiology	H6309	TEXAS	No
5	2085R0204X	Radiology	Vascular & Interventional Radiology	H6309	TEXAS	No
6	2085U0001X	Radiology	Diagnostic Ultrasound	H6309	TEXAS	No
7	2085R0202X	Radiology	Diagnostic Radiology	H6309	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	133918605	MEDICAID	TEXAS
2	E40792	MEDICARE UPIN	TEXAS
3	85340R	MEDICARE ID-TYPE UNSPECIFIED	TEXAS

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: 3/30/2025

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