Individual
CLOYCE L. STETSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 4TH ST, SUITE 4A100, LUBBOCK, TX 79430-9400
(806) 743-1842
(806) 743-1105
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-3596
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
J9557
TX
207ND0900X
Dermatopathology Physician
Primary
J9557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163190A
—
OK
05
—
119034001
—
TX
05
—
119034002
—
TX
01
—
124783100
FIRSTCARE COMMERCIAL
TX
05
—
124783101
—
TX
01
—
201021543
PRESBYTERIAN COMMERCIAL
NM
05
—
201021543
—
NM
01
—
80580S
BC/BS
TX
01
—
80948Z
HMO BLUE
TX
01
—
A363
TRIWEST
—
05
—
S4956
—
NM
Enumeration date
06/01/2005
Last updated
12/02/2021
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