Provider Demographics
NPI:1730747908
Name:INTERVENTIONAL PARTNERS
Entity type:Organization
Organization Name:INTERVENTIONAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-850-5760
Mailing Address - Street 1:PO BOX 734292
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4292
Mailing Address - Country:US
Mailing Address - Phone:469-850-5760
Mailing Address - Fax:469-716-4193
Practice Address - Street 1:19016 STONE OAK PKWY STE 180
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3281
Practice Address - Country:US
Practice Address - Phone:210-504-4304
Practice Address - Fax:210-504-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty