DR. THEODORE DAKE M.D. NPI 1073506234

NPI Information

  • NPI: 1073506234
  • Provider Name: DR. THEODORE DAKE, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 310 STAGECOACH TRL
    SUITE 300
    SAN MARCOS, TX
    ZIP 78666
  • Phone: (512) 392-3398

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NPI Details

DR. Theodore Dake, M.D. is a specialist in San Marcos, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Theodore Dake, M.D. NPI is 1073506234. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

310 STAGECOACH TRL
SUITE 300
SAN MARCOS, TX
ZIP 78666-134
Phone: (512) 392-3398
Fax: (512) 392-2890

The NPI 1073506234 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/23/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistE9594TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18M0870OTHERTEXASBLUE CROSS BLUE SHIELD
200FC30MEDICARE ID-TYPE UNSPECIFIEDTEXAS
3B22098MEDICARE UPINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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