| Indiemd TX Management LLC | |
|
309 Water St Ste 108 Boerne TX 78006-2866 | |
| (877) 988-7420 | |
| Not Available |
| Full Name | Indiemd TX Management LLC |
|---|---|
| Speciality | General Practice |
| Location | 309 Water St Ste 108, Boerne, Texas |
| Authorized Official Name and Position | Jason Ryan Frazier (OWNER) |
| Authorized Official Contact | 8779887420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiemd TX Management LLC 309 Water St Ste 108 Boerne TX 78006-2866 Ph: (877) 988-7420 | Indiemd TX Management LLC 309 Water St Ste 108 Boerne TX 78006-2866 Ph: (877) 988-7420 |
| NPI Number | 1740903434 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 3678928462 |
|---|---|
| Medicare Enrollment ID | O20231013002956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740903434 | NPI | - | NPPES |
| Provider Name | Darlynn Chaicha Chang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104971043 PECOS PAC ID: 7810070190 Enrollment ID: I20080208000502 |
| Provider Name | Alanna Guerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922427947 PECOS PAC ID: 0446478747 Enrollment ID: I20140828001220 |
| Provider Name | Sara Rosado |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801884713 PECOS PAC ID: 2365759644 Enrollment ID: I20150918001280 |
| Provider Name | Lyn M Akhil |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326415282 PECOS PAC ID: 3173826518 Enrollment ID: I20160119002660 |
| Provider Name | Rochelle Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043685829 PECOS PAC ID: 6608097548 Enrollment ID: I20160125001291 |
| Provider Name | Stephen M Hendrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871950527 PECOS PAC ID: 4284939406 Enrollment ID: I20160226000417 |
| Provider Name | Alissa Nicole Robbins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003365206 PECOS PAC ID: 0547549669 Enrollment ID: I20161114000970 |
| Provider Name | Kristen Sosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144622333 PECOS PAC ID: 4587946686 Enrollment ID: I20170125002354 |
| Provider Name | Tina Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417494303 PECOS PAC ID: 5496026601 Enrollment ID: I20170807002153 |
| Provider Name | Travis Chad Harney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992215792 PECOS PAC ID: 7517233216 Enrollment ID: I20171025000916 |
| Provider Name | Kristy Salaz Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659848364 PECOS PAC ID: 1153665757 Enrollment ID: I20181210000605 |
| Provider Name | Colin J Kugelmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366003246 PECOS PAC ID: 0446689939 Enrollment ID: I20200403002771 |
| Provider Name | Daniel Maman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194292276 PECOS PAC ID: 4587906631 Enrollment ID: I20200803003498 |
| Provider Name | Kristy K Mcclure-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639416803 PECOS PAC ID: 0749696706 Enrollment ID: I20210317001158 |
| Provider Name | Yoni Samocha |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265852008 PECOS PAC ID: 1557624301 Enrollment ID: I20210922000225 |
| Provider Name | Sydnee a Ramsey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972151306 PECOS PAC ID: 3779960612 Enrollment ID: I20220516002184 |
| Provider Name | Jacqueline Mills |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942559703 PECOS PAC ID: 1557660305 Enrollment ID: I20220721000559 |
| Provider Name | Melissa a Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346960481 PECOS PAC ID: 7214305119 Enrollment ID: I20221128001162 |
| Provider Name | Brianna Lynn Plank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730884644 PECOS PAC ID: 9335504869 Enrollment ID: I20230504002909 |
| Provider Name | Meagan Desmet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386343093 PECOS PAC ID: 9830544907 Enrollment ID: I20231010000456 |
| Provider Name | May Song Kiker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568236933 PECOS PAC ID: 5496103897 Enrollment ID: I20231125000326 |
| Provider Name | Joshua Steven Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902675168 PECOS PAC ID: 5294176657 Enrollment ID: I20240516000352 |
| Provider Name | Jamie Garcia Bonnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316595853 PECOS PAC ID: 1052857323 Enrollment ID: I20240723001402 |
| Provider Name | Jessica Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003544453 PECOS PAC ID: 1254865462 Enrollment ID: I20241111003329 |
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