Theodore Dake JR. M.D.

NPI 1073506234 - Specialist - 174400000X

NPI Details
NPI 1073506234
Gender Male
Enumeration Date 08/23/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
310 STAGECOACH TRL
SUITE 300
SAN MARCOS TX, 78666-5134, US
Phone (512) 392-3398
Fax (512) 392-2890
Business Location
310 STAGECOACH TRL
SUITE 300
SAN MARCOS TX, 78666-5134, US
Phone (512) 392-3398
Fax (512) 392-2890
Toxanomy
Taxonomy Code 174400000X
License State Texas
License Number E9594
Remove 1073506234 NPI Number
 

According to our database, Dr. Theodore Dake JR. M.D. NPI is 1073506234, taxonomy code is 174400000X and license number is E9594, license state is located at Texas. Theodore Dake JR. M.D. physically located at 310 Stagecoach Trl, San Marcos TX, 78666-5134. NPI Number Theodore Dake JR. M.D. has the Individual type.

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1073506234 NPI number is provided on an as is basis without warranty of any kind. 1073506234 is maintained by the National Plan & Provider Enumeration System. The contents of Theodore Dake JR. M.D. are for informational purposes only.