Individual
KEVIN P LALLY
Active
Individual
KEVIN P LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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