| NPI | 1497801211 |
|---|---|
| Other Name | MARTIN DERUSHA, JR., D.O. |
| Entity Type | Organization |
| Authorized Contact | MARTIN ALLYN DERUSHA Owner 817-882-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K0454) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |