Healthcare Provider Details

I. General information

NPI: 1831115906
Provider Name (Legal Business Name): VISIONWORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GOLF MILL CTR STE 255
NILES IL
60714-5658
US

IV. Provider business mailing address

175 E HOUSTON ST
SAN ANTONIO TX
78205-2255
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-2286
  • Fax: 847-759-3452
Mailing address:
  • Phone: 210-524-6663
  • Fax: 210-524-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

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