Healthcare Provider Details

I. General information

NPI: 1841590353
Provider Name (Legal Business Name): SEEMA SABU PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2010
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 GRANDE BLVD SE
RIO RANCHO NM
87124-1756
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-8735
  • Fax: 505-272-8737
Mailing address:
  • Phone: 505-272-1476
  • Fax: 855-894-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2010-0047
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: