Healthcare Provider Details

I. General information

NPI: 1659974327
Provider Name (Legal Business Name): INTERVENTIONAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23510 KINGSLAND BLVD STE 100
KATY TX
77494-4125
US

IV. Provider business mailing address

8135 FOREST LN # 515057
DALLAS TX
75230-2472
US

V. Phone/Fax

Practice location:
  • Phone: 281-565-0033
  • Fax: 281-565-0568
Mailing address:
  • Phone: 469-850-5760
  • Fax: 469-716-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JARYD STEIN
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 213-392-4976