Healthcare Provider Details

I. General information

NPI: 1043647811
Provider Name (Legal Business Name): VISIONWORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 WYOMING BLVD NE STE. C-1
ALBUQUERQUE NM
87113-2009
US

IV. Provider business mailing address

175 E HOUSTON ST
SAN ANTONIO TX
78205-2255
US

V. Phone/Fax

Practice location:
  • Phone: 505-797-1996
  • Fax:
Mailing address:
  • Phone:
  • 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: MRS. DOROTHY REYNOLDS
Title or Position: DIRECTOR
Credential:
Phone: 210-524-6515