1. Home
  2. Directory
  3. Texas
  4. San Marcos
  5. Specialist
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. THEODORE DAKE JR. M.D.
NPI 1073506234
Specialist in San Marcos, TX

Active since August 23, 2005Opted out of Medicare · through Oct 1, 2027
310 STAGECOACH TRL, SUITE 300, SAN MARCOS, TX 78666(512) 392-3398(512) 392-2890 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Theodore Dake Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE DAKE JR. M.D. (NPI 1073506234) is an individual specialist in San Marcos, Texas, licensed in Texas (E9594) and active in the NPI registry since August 2005. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1073506234
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. THEODORE DAKE JR.Credential: M.D.
Location Address310 STAGECOACH TRL, SUITE 300San Marcos, TX 78666-5134
Mailing Address310 Stagecoach Trl, Suite 300San Marcos, TX 78666-5134 · (512) 392-3398 · Fax (512) 392-2890
Phone(512) 392-3398
Fax(512) 392-2890
Sole ProprietorNo
Enumeration DateAugust 23, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1073506234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · E9594
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.
310 STAGECOACH TRL, San Marcos, TX 78666
Open in Google Maps ↗

Other Identifiers 1

Other8M0870TX · Blue Cross Blue Shield

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Theodore Dake Jr. M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2019 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2019
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. THEA DAKE LCSW
Social Worker (Clinical)
310 STAGECOACH TRL, SUITE 300
SAN MARCOS, TX 78666
Hays County (512) 392-3398
T A CASTOLDI & ASSOCIATES
General Practice
310 STAGECOACH TRL, SUITE 200 B
SAN MARCOS, TX 78666
Hays County (512) 396-5300
WILLIAM RANDOLPH ROGERS D.O.
Family Medicine (Adult Medicine)
310 STAGECOACH TRL, SUITE 200
SAN MARCOS, TX 78666
Hays County (512) 396-4700
DR. LARRY DUANE MOLENDA DDS
Dentist (General Practice)
310 STAGECOACH TRL, STE 800
SAN MARCOS, TX 78666
Hays County (512) 392-5845
MS. PATRICIA ROUISSE BALLENTINE R.N., MSN, FNP-C
Nurse Practitioner (Family)
310 STAGECOACH TRL, SUITE 200A
SAN MARCOS, TX 78666
Hays County (512) 396-4700
DR. JOSEPH CLABERON SULLIVAN III DDS
Dentist (General Practice)
310 STAGECOACH TRL, SUITE 700
SAN MARCOS, TX 78666
Hays County (512) 396-4288
DR. GEORGE M GRANT DDS PHD
Dentist (Oral and Maxillofacial Surgery)
310 STAGECOACH TRL, SUITE 600
SAN MARCOS, TX 78666
Hays County (512) 396-4689

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Dake's NPI number?

The NPI number for Theodore Dake is 1073506234. It was assigned to this individual provider in the NPPES registry on August 23, 2005.

Where is Theodore Dake located?

Theodore Dake practices at 310 Stagecoach Trl Suite 300, San Marcos, TX 78666. The listed phone number is (512) 392-3398.

What is Theodore Dake's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Theodore Dake enrolled in Medicare?

No. Theodore Dake has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Theodore Dake was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.