Provider Demographics
NPI:1790877595
Name:ROCQUE, ROBERT CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CRAIG
Last Name:ROCQUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:607 PARK GROVE DR
Mailing Address - Street 2:STE B
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5591
Mailing Address - Country:US
Mailing Address - Phone:281-392-1210
Mailing Address - Fax:281-392-1249
Practice Address - Street 1:607 PARK GROVE DR
Practice Address - Street 2:STE B
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5591
Practice Address - Country:US
Practice Address - Phone:281-392-1210
Practice Address - Fax:281-392-1249
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX9641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30-0234421OtherTIN