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General NPI Number Information
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NPI Number | 1750462958
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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 | 10/17/2006
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2924 N ROOSEVELT BLVD
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City | KEY WEST
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State | FL
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Zip | 33040-4012
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Country | US
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Telephone | 305-295-2505
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Fax | 305-295-2563
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Provider Business Mailing Address
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Address Line | 11103 WEST AVENUE SUITE #6
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City | SAN ANTONIO
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State | TX
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Zip | 78213
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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 | OFFICER
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Name | DOUG NEWCOM
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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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