Provider Demographics
NPI:1134117450
Name:STEGEMANN, LLOYD H (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:H
Last Name:STEGEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5826 ESPLANADE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4173
Mailing Address - Country:US
Mailing Address - Phone:361-500-2898
Mailing Address - Fax:
Practice Address - Street 1:5826 ESPLANADE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4173
Practice Address - Country:US
Practice Address - Phone:361-500-2898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5917208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158332001Medicaid
TX8F9151OtherBLUE CROSS BLUE SHIELD
TX158332001Medicaid
TX158332001Medicaid