Provider Demographics
NPI:1154315596
Name:LUQUETTE, DAVID ALLEN (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:LUQUETTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1874
Mailing Address - Country:US
Mailing Address - Phone:936-569-0200
Mailing Address - Fax:936-569-0262
Practice Address - Street 1:4721 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1874
Practice Address - Country:US
Practice Address - Phone:936-569-0200
Practice Address - Fax:936-569-0262
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80020SOtherBCBS
U52298Medicare UPIN
00020RMedicare ID - Type Unspecified