Healthcare Provider Details

I. General information

NPI: 1508422395
Provider Name (Legal Business Name): INTERVENTIONAL PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 OLTON RD STE C
PLAINVIEW TX
79072-6653
US

IV. Provider business mailing address

8135 FOREST LN # 515057
DALLAS TX
75230-2472
US

V. Phone/Fax

Practice location:
  • Phone: 806-293-3980
  • Fax: 806-793-9278
Mailing address:
  • Phone: 469-850-5760
  • Fax: 469-716-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JARYD STEIN
Title or Position: OWNER/ CHIEF EXECUTIVE DIRECTOR
Credential: MD
Phone: 213-392-4976