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

General Provider Information

NPI Number	:	1306406426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS, INC

Provider Business Mailing Address
First Line	:	175 E HOUSTON ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2255
Country	:	US
Telephone Number	:	702-833-1288
Fax Number	:	702-614-4798

Provider Business Practice Location Address
First Line	:	6870 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2106
Country	:	US
Telephone Number	:	702-833-1288
Fax Number	:	702-614-4798

Authorized Official
Title or Position	:	VP OF MANAGED VISION CARE
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	800-340-0129

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	12/09/2021

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Directions to “VISIONWORKS, INC ” Practice Location

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