Individual
RUKAN DACCAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4450 E SAM HOUSTON PKWY S, STE H2, PASADENA, TX 77505-3950
(713) 910-7779
(713) 910-7760
Mailing address
PO BOX 405, SOUTH HOUSTON, TX 77587-0405
(713) 910-7779
(713) 910-7760
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
J8980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077AS
BCBSTX
TX
05
—
096904002
—
TX
01
—
181878301
MEDICAID PIN
TX
Enumeration date
06/20/2006
Last updated
05/25/2011
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