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General NPI Number Information
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NPI Number | 1992124432
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Entity Type | Organization
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Legal Business Name | TEXAS FEDERAL WELLNESS CENTER, PLLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 2715 W TRENTON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3433
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Country | US
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Telephone | 956-618-4878
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Fax | 956-618-4879
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Provider Business Mailing Address
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Address Line | 2715 W TRENTON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3433
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Country | US
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Telephone | 956-618-4878
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Fax | 956-618-4879
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS E MARTENS
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Credential | DO
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Telephone | 956-618-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State | TX
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Taxonomy #3
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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 | TX
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