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General NPI Number Information
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NPI Number | 1013445444
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Entity Type | Organization
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Legal Business Name | FEDERAL COMP AND WELLNESS TEMPLE PLLC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 18817 N HEATHERWILDE BLVD STE 150
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-1750
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Country | US
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Telephone | 512-523-4878
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Fax | 512-870-9770
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Provider Business Mailing Address
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Address Line | 18817 N HEATHERWILDE BLVD STE 150
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-1750
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Country | US
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Telephone | 512-523-4878
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Fax | 512-870-9770
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. THOMAS E MARTENS
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Credential | DO
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Telephone | 512-523-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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