MEDICARE: ALAN LO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MT188131	PA
2	207P00000X	Emergency Medicine Physician	Q4625	TX

General Provider Information

NPI Number	:	1871786640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN LO

Provider Business Mailing Address
First Line	:	26400 KUYKENDAHL RD STE C180-127
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-2882
Country	:	US
Telephone Number	:	703-493-0296
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4482
Country	:	US
Telephone Number	:	281-441-6520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	12/13/2022

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Directions to “ ALAN LO ” Practice Location

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