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General NPI Number Information
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NPI Number | 1912626110
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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 | 08/23/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 336 W PRIEN LAKE RD
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8453
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Country | US
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Telephone | 337-474-3395
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Fax | 337-474-3397
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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 | 78205-2299
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Country | US
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Telephone | 726-444-4148
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Fax | 210-524-6587
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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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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