Healthcare Provider Details

I. General information

NPI: 1750039236
Provider Name (Legal Business Name): PARKER THOMAS TRENT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIRCLE BLDG 7500, SECOND FLOOR, ROOM 2200
COLORADO SPRINGS CO
80913
US

IV. Provider business mailing address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7450
  • Fax:
Mailing address:
  • Phone: 719-526-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.149136
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: