Provider Demographics
NPI:1053976365
Name:FEDERAL COMP AND WELLNESS NOLANVILLE, PLLC
Entity type:Organization
Organization Name:FEDERAL COMP AND WELLNESS NOLANVILLE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-523-4878
Mailing Address - Street 1:18817 N HEATHERWILDE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-1750
Mailing Address - Country:US
Mailing Address - Phone:512-523-4878
Mailing Address - Fax:512-870-9770
Practice Address - Street 1:1875 E CENTRAL TEXAS EXPY STE A
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-8490
Practice Address - Country:US
Practice Address - Phone:254-449-9099
Practice Address - Fax:512-870-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty