Martin A. Derusha, Jr , D O, , PA
Martin A. Derusha, Jr , D O, , PA provides Family Medicine Physician services in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2007.
- Licensed in
- TX
- In the registry since
- 2007
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1510 Pennsylvania AveFort Worth, TX 76104-2027
Phone: (817) 882-0984
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence K0454 (TX) |
|---|
Record details
| NPI number | 1497801211 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Martin Derusha — Owner · (817) 882-0984 |
| Other names | Martin Derusha, Jr., D.O. |
| NPI enumerated | January 26, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 1510 Pennsylvania Ave, Fort Worth, TX 76104-2027 |
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