Individual
RYAN LUKE FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-6604
Mailing address
30 JUNIPER WAY, BASKING RIDGE, NJ 07920-1205
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101276646
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2021
Last updated
11/20/2022
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