Provider Demographics
NPI:1093714826
Name:ARKUSINSKI, JOHN BRUNO (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRUNO
Last Name:ARKUSINSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S CLAY ST STE A
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4530
Mailing Address - Country:US
Mailing Address - Phone:903-229-4292
Mailing Address - Fax:903-229-4288
Practice Address - Street 1:206 S CLAY ST STE A
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4530
Practice Address - Country:US
Practice Address - Phone:469-256-2525
Practice Address - Fax:469-256-2164
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152025601Medicaid
TX152025601Medicaid
H34101Medicare UPIN