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Individual

DR. JOHN WILLIAM LALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-9351
Mailing address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-9351

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2019007499
MO
207Y00000X
Otolaryngology Physician
T7272
TX
208D00000X
General Practice Physician
2019007499
MO
390200000X
Student in an Organized Health Care Education/Training Program
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
12/12/2016
Last updated
03/10/2026
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