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 |