Healthcare Provider Details

I. General information

NPI: 1568889111
Provider Name (Legal Business Name): VISIONWORKS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4890 BIG ISLAND DR
JACKSONVILLE FL
32246-7490
US

IV. Provider business mailing address

PO BOX 848448
DALLAS TX
75284-8448
US

V. Phone/Fax

Practice location:
  • Phone: 904-642-5658
  • Fax: 904-642-7343
Mailing address:
  • Phone: 210-524-6771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DOROTHY REYNOLDS
Title or Position: DIRECTOR MVC
Credential:
Phone: 210-524-6515