MEDICARE: VISIONWORKS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1033358254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS, INC

Provider Business Mailing Address
First Line	:	PO BOX 848448
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-8448
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	7208 W. 191ST STREET
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60487
Country	:	US
Telephone Number	:	815-464-0668
Fax Number	:	815-464-0876

Authorized Official
Title or Position	:	VP MANAGED VISION CARE
Name	:	DOUG NECOM
Credential	:
Telephone Number	:	210-524-6700

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	03/12/2019

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Directions to “VISIONWORKS, INC ” Practice Location

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