Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Trent J Fackelman, FNP-C

Individual provider Registered Nurse · NPI 1407466410

Trent J Fackelman, FNP-C is a Nurse Practitioner in San Antonio, Texas. Qualified in 2020, 6 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2020
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

8500 Village Dr Ste 202
San Antonio, TX 78217-5510
Phone: (210) 957-1419
Fax: (210) 957-1697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1007822 (TX)
Registered Nurse Taxonomy 163W00000X · Licence 816398 (TX)

Record details

NPI number1407466410
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedAugust 4, 2020
Last updated in NPPESSeptember 13, 2022
Certification dateSeptember 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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