Healthcare Provider Details
I. General information
NPI: 1659658961
Provider Name (Legal Business Name): VISIONWORKS, INC,
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2011
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1335 G ST NW
WASHINGTON DC
20005-3102
US
IV. Provider business mailing address
PO BOX 848448
DALLAS TX
75284-8448
US
V. Phone/Fax
- Phone: 202-783-7171
- Fax: 202-783-0029
- Phone: 210-524-6663
- Fax: 210-524-6587
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DOROTHY
REYNOLDS
Title or Position: MVC DIRECTOR
Credential:
Phone: 210-524-6515