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	:	1033664297
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	:	210-524-3531
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	2210 N RICHMOND RD
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60051-5423
Country	:	US
Telephone Number	:	815-344-2916
Fax Number	:	815-344-2917

Authorized Official
Title or Position	:	VP, RETAIL MANAGED CARE
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	210-524-6515

Provider Enumeration Date	:	08/17/2016
Last Update Date	:	08/17/2016

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Directions to “VISIONWORKS, INC ” Practice Location

Language	Start Address	Practice Location

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