Individual
KEVIN P LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, 1400, HOUSTON, TX 77030-3000
(832) 325-7234
(713) 512-2221
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
H9668
TX
2086S0120X
Pediatric Surgery Physician
Primary
H9668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137118901
CSHCN
TX
05
—
137118905
—
TX
05
—
137118917
—
TX
01
—
137118918
MEDICAID-CSHCN
TX
01
—
81Z193
BCBS
TX
01
—
82M033
BCBS
TX
Enumeration date
07/06/2006
Last updated
03/03/2023
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