Healthcare Provider Details
I. General information
NPI: 1467085795
Provider Name (Legal Business Name): INTERVENTIONAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2020
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 W ARBROOK BLVD STE 201
ARLINGTON TX
76014-3176
US
IV. Provider business mailing address
8135 FOREST LN # 515057
DALLAS TX
75230-2472
US
V. Phone/Fax
- Phone: 817-467-1990
- Fax: 817-466-8737
- Phone: 469-850-5760
- Fax: 469-716-4193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JARYD
STEIN
Title or Position: OWNER/CHIEF EXECUTIVE DIRECTOR
Credential: MD
Phone: 213-392-4976