MEDICARE: VISION WORLD 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154406692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION WORLD INC

Provider Business Mailing Address
First Line	:	PO BOX 846250
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6250
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	2116 FORD PKWY
Second Line	:	ST PAUL
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1813
Country	:	US
Telephone Number	:	651-699-1130
Fax Number	:	561-690-2871

Authorized Official
Title or Position	:	OFFICER
Name	:	DOUG NEWCOM
Credential	:
Telephone Number	:	210-524-6700

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/29/2008

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Directions to “VISION WORLD INC ” Practice Location

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