Individual provider Active NPI

Dacia Judith Ticas, M.D.

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1083140594
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T0957 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-7885
NPI assigned
May 3, 2017
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60485 AZ
Emergency Medicine Physician 207P00000X T0957 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

6431 Fannin St
JJL 270
Houston, TX 77030

Other practice location 1

11049 Memorial Hermann Dr Ste 200
Pearland, TX 77584-3307
Phone (346) 680-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929000755 TX Practitioner - Emergency MedicinePractitioner - Sports Medicine 6204108806 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Sports Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

10905 Memorial Hermann Dr
Suite 130
Pearland, TX 77584-3773
Phone (713) 486-6000

6410 Fannin St
Houston, TX 77030-3005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Emergency Medicine CurrentSince Nov 22, 2024 Accepting new patients
Baylor College of Medicine Family Medicine CurrentSince Jun 25, 2021 Accepting new patients
Baylor College of Medicine CurrentSince Jun 25, 2021 Accepting new patients
Ut Physicians CurrentSince Nov 22, 2024 Accepting new patients
Baylor College of Medicine Sports Medicine CurrentSince Jun 25, 2021 Accepting new patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Oct 9, 2021 Accepting new patients
Baylor College of Medicine Family Medicine CurrentSince Jun 25, 2021 Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6410 Fannin St
#135
Houston, TX 77030

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 9
Houston, TX 77030
Phone (713) 798-2273

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

4500 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 487-2786

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

10905 Memorial Hermann Dr
Pearland, TX 77584
Phone (713) 486-6000

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1083140594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "JJL 270",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11049 Memorial Hermann Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775843307",
            "country_code": "US",
            "telephone_number": "346-680-0001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TICAS",
        "first_name": "DACIA",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "60485",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T0957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.