Rukan Daccak, MD, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

J8980 Issued in TX

Legal business name

RUKAN DACCAK, MD, PA

Practice address

4450 E Sam Houston Pkwy S Ste H2
Pasadena, TX 77505-3950

Phone

(713) 910-7779

Fax

(713) 910-7760

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Rukan Daccak, MDNPI 1780629840

Title

Owner

Phone

(713) 910-7779

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Digestive System Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rukan Daccak, M.D.

  • Gastroenterology Physician
  • Pasadena, TX
  • NPI 1780629840
  Medicare reassignment Authorized official
• Shaletra Jordan

  • Certified Registered Nurse Anesthetist
  • Carthage, TX
  • NPI 1699164285
  Medicare reassignment NPD
• Heather Rae Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, IN
  • NPI 1851669279

  TX

  Medicare reassignment NPD
• Krystal Bowman Agbahiwe, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1316212210
  Medicare reassignment
• Janney Gonzalez Gutierrez, FNP-C

  • Family Nurse Practitioner
  • Pasadena, TX
  • NPI 1063044352
  Medicare reassignment
• Brenda Wren McCall, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1386629624
  Medicare reassignment

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1104951979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405",
            "city": "SOUTH HOUSTON",
            "state": "TX",
            "postal_code": "775870405",
            "telephone_number": "713-910-7779",
            "fax_number": "713-910-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 E SAM HOUSTON PKWY S STE H2",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053950",
            "telephone_number": "713-910-7779",
            "fax_number": "713-910-7760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4543 Post Oak Place Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770273103",
            "country_code": "US",
            "telephone_number": "713-910-7779",
            "fax_number": "713-910-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RUKAN DACCAK, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "DACCAK",
        "authorized_official_first_name": "RUKAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-910-7779",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J8980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096904002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Digestive System Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Digestive System Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rubi Marconi DDS PLLC
• Jill Rubolino, APRN
• Natasha Andrea Ruda, PA
• Anna Elizabeth Rueda, M.D.
• Lataysha Chervette Ruffin
• Idette Rumann, PH.D
• S. E Complete Family Care
• S.a.K. Professionals Inc.
• S.E. Complete Family Care
• Luis A Sabatini, MD

• Specialist in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.