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Organization
INDIEMD TX MANAGEMENT LLC
Active
Organization
INDIEMD TX MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON RYAN FRAZIER (OWNER)
(877) 988-7420
Entity
Organization
Contact information
Practice address
309 WATER ST STE 108, BOERNE, TX 78006-2866
(877) 988-7420
Mailing address
309 WATER ST STE 108, BOERNE, TX 78006-2866
(877) 988-7420
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
—
NULL
202D00000X
Integrative Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
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
08/28/2024
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