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1922046507
MARTIN A DERUSHA
FORT WORTH, TX
NPI
1922046507
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: TX K0454)
Enumeration Date
2006-06-03
Last Update Date
2023-03-07
Business Address
-- MARTIN A DERUSHA DO
1506 PENNSYLVANIA AVE
FORT WORTH, TX 76104-2027
Phone number: 817-882-0984
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Mailing Address
-- MARTIN A DERUSHA DO
1506 PENNSYLVANIA AVE
FORT WORTH, TX 76104-2027
Phone number: 817-882-0984
Copy
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