Theodore Dake Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

E9594 Issued in TX

Practice address

310 Stagecoach TRL
Suite 300
San Marcos, TX 78666-5134

Phone

(512) 392-3398

Fax

(512) 392-2890

NPI assigned

Aug 23, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Austin Neuropsychiatric Associates

  • Clinical Social Worker
  • San Marcos, TX
  • NPI 1336327626
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073506234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 STAGECOACH TRL",
            "address_2": "SUITE 300",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665134",
            "telephone_number": "512-392-3398",
            "fax_number": "512-392-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 STAGECOACH TRL",
            "address_2": "SUITE 300",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665134",
            "telephone_number": "512-392-3398",
            "fax_number": "512-392-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKE",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E9594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8M0870",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Ellen Curtis, OTR
• CVS Pharmacy Inc (CVS Pharmacy #07422)
• CVS Pharmacy Inc. (CVS Pharmacy #)
• CVS Pharmacy, Inc. (CVS Pharmacy #05776)
• Thea Dake, LCSW
• Renee Dallasandro
• Daniel a. Frederick, M.D., P.a. (Central Texas Pain Center)
• Kristie S. Dapp, APRN-BC,FNP
• Patrick John Dattore, PH.D.
• David C Jones MD PA

• Specialist in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.