Provider Demographics
NPI:1831304161
Name:STEIN, JARYD (MD)
Entity Type:Individual
Prefix:DR
First Name:JARYD
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 COIT RD
Mailing Address - Street 2:STE 505
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2038
Mailing Address - Country:US
Mailing Address - Phone:214-382-3200
Mailing Address - Fax:214-382-3201
Practice Address - Street 1:12400 COIT RD STE 505
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2038
Practice Address - Country:US
Practice Address - Phone:214-382-3200
Practice Address - Fax:214-382-3201
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM90292085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DF535OtherBCBS
TX54091OtherPARKLAND ID NUMBER