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Dr. Theodore Dake JR., MD
Specialist in San Marcos, Texas
NPI 1073506234

Theodore Dake JR. is a Specialist based in San Marcos, TX. Theodore Dake JR. practices in San Marcos, TX and has the professional credentials of MD. The NPI Number for Theodore Dake JR. is 1073506234 and holds a License No. E9594 (Texas).

The current practice location address for Theodore Dake JR. is 310 Stagecoach Trl, San Marcos, TX and can be reached out via phone at 512-392-3398 and via fax at 512-392-2890.

Location: 310 Stagecoach Trl, San Marcos, TX, 78666-5134
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073506234
Provider Name
Theodore Dake JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
310 Stagecoach Trl, San Marcos, TX, 78666-5134
Phone Number
512-392-3398
Fax Number
512-392-2890
Provider Enumeration Date
08/23/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8M0870 01 TX BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
310 Stagecoach Trl
City
San Marcos
State
Texas
Zip
78666-5134
Phone Number
512-392-3398
Fax Number
512-392-2890
person
Provider Business Mailing Address Details
Address
310 Stagecoach Trl
City
San Marcos
State
Texas
Zip
78666-5134
Phone Number
512-392-3398
Fax Number
512-392-2890
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
E9594 (Texas)
Definition
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.
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