MARTIN DERUSHA, JR., D.O.
NPI 1497801211
Family Medicine in Fort Worth, TX

Q: What is Martin A. Derusha, Jr., D.O,, P.A.'s NPI number?

The NPI number for Martin A. Derusha, Jr., D.O,, P.A. is 1497801211. It was assigned to this organization in the NPPES registry on January 26, 2007. The provider is also known as Martin Derusha, Jr., D.O..

Q: What is Martin A. Derusha, Jr., D.O,, P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since January 26, 2007

1510 PENNSYLVANIA AVE, FORT WORTH, TX 76104(817) 882-0984 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Martin Derusha, Jr., D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARTIN DERUSHA, JR., D.O. (NPI 1497801211) is a healthcare organization registered as a family medicine in Fort Worth, Texas and active in the NPI registry since January 2007. The organization lists Martin Allyn Derusha, Owner, as its authorized official.

NPPES Registry Identity

NPI1497801211

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameMARTIN A. DERUSHA, JR., D.O,, P.A.

Location Address1510 PENNSYLVANIA AVEFort Worth, TX 76104-2027

Mailing Address1510 Pennsylvania AveFort Worth, TX 76104-2027 · (817) 882-0984

Phone(817) 882-0984

Organization SubpartNo

Authorized OfficialMartin Allyn DerushaOwner · (817) 882-0984

Enumeration DateJanuary 26, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1497801211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · K0454

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1510 PENNSYLVANIA AVE, Fort Worth, TX 76104

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Other Names 1

Other NameMartin Derusha, Jr., D.o.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Martin A. Derusha, Jr., D.O,, P.A.'s NPI number?

The NPI number for Martin A. Derusha, Jr., D.O,, P.A. is 1497801211. It was assigned to this organization in the NPPES registry on January 26, 2007. The provider is also known as Martin Derusha, Jr., D.O..

Where is Martin A. Derusha, Jr., D.O,, P.A. located?

Martin A. Derusha, Jr., D.O,, P.A. is located at 1510 Pennsylvania Ave, Fort Worth, TX 76104. The listed phone number is (817) 882-0984.

What is Martin A. Derusha, Jr., D.O,, P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Martin A. Derusha, Jr., D.O,, P.A. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.