Provider Demographics
NPI:1740235605
Name:KENNETH ALO MD PA
Entity Type:Organization
Organization Name:KENNETH ALO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-357-1370
Mailing Address - Street 1:845 FM 1960 RD W STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3942
Mailing Address - Country:US
Mailing Address - Phone:281-357-1370
Mailing Address - Fax:281-516-7693
Practice Address - Street 1:845 FM 1960 RD W STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3942
Practice Address - Country:US
Practice Address - Phone:281-357-1370
Practice Address - Fax:281-516-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7865174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00128XMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER