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Organization
INDIEMD NETWORK LLC
Active
Organization
INDIEMD NETWORK LLC
Active
Other names
IndieMD Network
Organization subpart
No
Provider details
NPI number
Authorized official
JASON RYAN FRAZIER (MANAGING MEMBER)
(469) 682-5827
Entity
Organization
Contact information
Practice address
309 WATER ST STE 107, BOERNE, TX 78006-2866
(469) 682-5827
Mailing address
250 STATE HIGHWAY 46 W, BOERNE, TX 78006-8118
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
NULL
163WW0000X
Wound Care Registered Nurse
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/19/2022
Last updated
04/06/2023
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