1770147878 NPI number — INTERVENTIONAL PARTNERS PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770147878 NPI number — INTERVENTIONAL PARTNERS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERVENTIONAL PARTNERS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770147878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8135 FOREST LN # 515057
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75230-2472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-850-5760
Provider Business Mailing Address Fax Number:
469-716-4193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4201 MEDICAL CENTER DR STE 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75069-1765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-382-3200
Provider Business Practice Location Address Fax Number:
214-382-3201
Provider Enumeration Date:
04/24/2019

Additional Information

Authorized Official

Authorized Official Last Name:
STEIN
Authorized Official First Name:
JARYD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/CHIEF EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
213-392-4976

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7736730003 . This is a "NSC DME SUPPLIER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com