Provider Demographics
NPI:1477536266
Name:LLOYD, JEREMY D (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:D
Last Name:LLOYD
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:PO BOX 47044
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-7044
Mailing Address - Country:US
Mailing Address - Phone:210-520-3737
Mailing Address - Fax:210-520-1234
Practice Address - Street 1:10628 CULEBRA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1320
Practice Address - Country:US
Practice Address - Phone:210-520-3737
Practice Address - Fax:210-520-1234
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5607207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BZ176OtherBC/BSTX
TX164493202Medicaid
TX8BZ292OtherBCBSTX
TX8BZ176OtherBC/BSTX
TX164493202Medicaid