Healthcare Provider Details

I. General information

NPI: 1598381196
Provider Name (Legal Business Name): FEDERAL COMP AND WELLNESS WACO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N VALLEY MILLS DR
WACO TX
76710-2561
US

IV. Provider business mailing address

18817 N HEATHERWILDE BLVD STE 150
PFLUGERVILLE TX
78660-1750
US

V. Phone/Fax

Practice location:
  • Phone: 254-294-9600
  • Fax: 512-870-9770
Mailing address:
  • Phone: 512-523-4878
  • Fax: 512-870-9770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS EDWARD MARTENS
Title or Position: OWNER/CEO
Credential: DO
Phone: 512-523-4878