Provider Demographics
NPI:1518216811
Name:MINIMALLY INVASIVE INTERVENTIONAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:MINIMALLY INVASIVE INTERVENTIONAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARYD
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-392-4976
Mailing Address - Street 1:10501 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2220
Mailing Address - Country:US
Mailing Address - Phone:214-382-3200
Mailing Address - Fax:214-382-3201
Practice Address - Street 1:10501 N CENTRAL EXPY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2220
Practice Address - Country:US
Practice Address - Phone:214-382-3200
Practice Address - Fax:214-382-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty