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NPI 1467127084

NPI 1467127084 : VISIONWORKS, INC. : OLIVE BRANCH, MS

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General NPI Number Information
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    NPI Number           |    1467127084
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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     |    08/16/2021
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    Last Update Date     |    08/16/2021
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Provider Practice Location Address
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    Address Line         |    5218 GOODMAN RD STE 113 
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    City                 |    OLIVE BRANCH
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    State                |    MS
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    Zip                  |    38654-7985
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    Country              |    US
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    Telephone            |    726-444-4078
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    Fax                  |    
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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            |    726-444-4078
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    Fax                  |    210-524-6587
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Authorized Official
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    Title or Position    |    MANAGER OF NETWORK MANAGEMENT
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    Name                 |     DOLSIE  MCDONALD 
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    Credential           |    
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    Telephone            |    726-444-4078
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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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