Provider Demographics
NPI:1932780087
Name:SEARS, SAT NAM K (DOT)
Entity Type:Individual
Prefix:
First Name:SAT NAM
Middle Name:K
Last Name:SEARS
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13801 E BENSON HWY UNIT B
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-9064
Mailing Address - Country:US
Mailing Address - Phone:505-738-2256
Mailing Address - Fax:
Practice Address - Street 1:12775 E MARY ANN CLEVELAND WAY
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-8600
Practice Address - Country:US
Practice Address - Phone:520-879-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008346225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics