Healthcare Provider Details

I. General information

NPI: 1770850026
Provider Name (Legal Business Name): VISIONWORKS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N FREDERICK AVE
GAITHERSBURG MD
20879-3306
US

IV. Provider business mailing address

PO BOX 848448
DALLAS TX
75284-8448
US

V. Phone/Fax

Practice location:
  • Phone: 301-330-4972
  • Fax: 301-330-4369
Mailing address:
  • Phone: 210-524-6663
  • Fax: 210-524-6587

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: MVC DIRECTOR
Credential:
Phone: 210-524-6515