Provider Demographics
NPI:1144333055
Name:MARTENS, THOMAS E (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:MARTENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:18817 HEATHERWILDE BLVD
Practice Address - Street 2:STE 150
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7866
Practice Address - Country:US
Practice Address - Phone:512-523-4878
Practice Address - Fax:512-870-9770
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8125207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U7931OtherBLUE CROSS BLUE SHIELD
TXH07034Medicare UPIN