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General NPI Number Information
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NPI Number | 1033358254
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Entity Type | Organization
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Legal Business Name | VISIONWORKS, INC
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 7208 W. 191ST STREET
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City | TINLEY PARK
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State | IL
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Zip | 60487
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Country | US
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Telephone | 815-464-0668
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Fax | 815-464-0876
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Provider Business Mailing Address
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Address Line | PO BOX 848448
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City | DALLAS
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State | TX
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Zip | 75284-8448
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Country | US
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Telephone | 210-524-6663
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Fax | 210-524-6587
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Authorized Official
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Title or Position | VP MANAGED VISION CARE
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Name | DOUG NECOM
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Credential |
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Telephone | 210-524-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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