Provider Demographics
NPI:1184021701
Name:ERNEST S. SEARS, JR., MD
Entity Type:Organization
Organization Name:ERNEST S. SEARS, JR., MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:CUNNINGHAM
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-907-2497
Mailing Address - Street 1:1101 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-3227
Mailing Address - Country:US
Mailing Address - Phone:713-907-3867
Mailing Address - Fax:888-587-3512
Practice Address - Street 1:1101 N FRONT ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-3227
Practice Address - Country:US
Practice Address - Phone:713-907-3867
Practice Address - Fax:888-587-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE8563261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127915005Medicaid
TXB26305Medicare UPIN
TX81390NMedicare PIN