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General NPI Number Information
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NPI Number | 1174623961
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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 | 09/22/2006
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 1335 G STREET , NW
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City | WASHINGTON
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State | DC
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Zip | 20005
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Country | US
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Telephone | 202-783-7171
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Fax | 202-783-0029
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Provider Business Mailing Address
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Address Line | 175 E HOUSTON ST
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2255
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Country | US
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Telephone | 210-524-6803
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Fax | 210-524-6587
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL POTH
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Credential | OD
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Telephone | 703-288-1978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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