Healthcare Provider Details
I. General information
NPI: 1942528344
Provider Name (Legal Business Name): VISIONWORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2010
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950-A NW BLUE PARKWAY
LEE'S SUMMIT MO
64086
US
IV. Provider business mailing address
PO BOX 848448
DALLAS TX
75284-8448
US
V. Phone/Fax
- Phone: 816-246-1327
- Fax:
- 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
REYNOLD
Title or Position: DIRECTOR OF MANAGED VISION CARE
Credential:
Phone: 210-524-6515