MEDICARE: FEDERAL COMP AND WELLNESS SAN ANTONIO, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	L8125	TX
2	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1174039846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEDERAL COMP AND WELLNESS SAN ANTONIO, PLLC

Provider Business Mailing Address
First Line	:	18817 HEATHERWILDE BLVD
Second Line	:	STE 150
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2543
Country	:	US
Telephone Number	:	512-523-4878
Fax Number	:

Provider Business Practice Location Address
First Line	:	2515 BABCOCK RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4807
Country	:	US
Telephone Number	:	210-910-4949
Fax Number	:	512-870-9770

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. THOMAS EDWARD MARTENS
Credential	:	DO
Telephone Number	:	512-523-4878

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	04/29/2022

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