Healthcare Provider Details
I. General information
NPI: 1801451901
Provider Name (Legal Business Name): INTERVENTIONAL PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2019
Last Update Date: 02/28/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
124 EAST HWY 80 STE. 104
FORNEY TX
75126-8607
US
IV. Provider business mailing address
8135 FOREST LN # 515057
DALLAS TX
75230-2472
US
V. Phone/Fax
- Phone: 972-552-5599
- Fax: 972-289-8025
- Phone: 469-850-5760
- Fax: 469-716-4193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JARYD
STEIN
Title or Position: OWNER/CHIEF EXECUTIVE DIRECTOR
Credential: MD
Phone: 213-392-4976