Provider Demographics
NPI:1194226100
Name:SEARES, RAFFY YU (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RAFFY
Middle Name:YU
Last Name:SEARES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3494A SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3560
Mailing Address - Country:US
Mailing Address - Phone:870-571-4002
Mailing Address - Fax:903-306-2570
Practice Address - Street 1:3494A SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3560
Practice Address - Country:US
Practice Address - Phone:870-571-4002
Practice Address - Fax:903-306-2570
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-24
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3820225100000X
TX1233058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX401274201Medicaid