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	:	1285394858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS, INC

Provider Business Mailing Address
First Line	:	175 E HOUSTON ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2255
Country	:	US
Telephone Number	:	800-340-0129
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 POLARIS PKWY SPC 7A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-2037
Country	:	US
Telephone Number	:	614-768-7861
Fax Number	:	614-430-9324

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	DOLSIE MCDONALD
Credential	:
Telephone Number	:	210-524-6663

Provider Enumeration Date	:	12/23/2021
Last Update Date	:	08/11/2022

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Directions to “VISIONWORKS, INC ” Practice Location

Language	Start Address	Practice Location

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