Healthcare Provider Details

I. General information

NPI: 1518522804
Provider Name (Legal Business Name): INTERVENTIONAL PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 MATLOCK RD STE 103
MANSFIELD TX
76063-3443
US

IV. Provider business mailing address

8135 FOREST LN # 515057
DALLAS TX
75230-2472
US

V. Phone/Fax

Practice location:
  • Phone: 817-467-1990
  • Fax: 817-466-8737
Mailing address:
  • Phone: 469-850-5760
  • Fax: 469-716-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable 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