MEDICARE: VISIONWORKS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205245206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS INC

Provider Business Mailing Address
First Line	:	PO BOX 848448
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-8448
Country	:	US
Telephone Number	:	210-524-6771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 PALM BEACH LAKES BLVD
Second Line	:	STE B01
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2031
Country	:	US
Telephone Number	:	561-689-8236
Fax Number	:	561-689-8237

Authorized Official
Title or Position	:	DIRECTOR - MVC
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	210-524-6515

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	04/30/2019

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Directions to “VISIONWORKS INC ” Practice Location

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