Provider Demographics
NPI:1053678300
Name:TERENCE A TRINKA O.D. PC
Entity Type:Organization
Organization Name:TERENCE A TRINKA O.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TRINKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-838-9355
Mailing Address - Street 1:26689 PLEASANT PARK RD
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7703
Mailing Address - Country:US
Mailing Address - Phone:303-838-9355
Mailing Address - Fax:303-838-9526
Practice Address - Street 1:26689 PLEASANT PARK RD
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7703
Practice Address - Country:US
Practice Address - Phone:303-838-9355
Practice Address - Fax:303-838-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1187261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center