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	152W00000X	Optometrist

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	:	1518041425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION WORLD, INC.

Provider Business Mailing Address
First Line	:	11103 WEST AVE
Second Line	:	STE 6
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1370
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	100 S FEDERAL AVE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-3750
Country	:	US
Telephone Number	:	641-423-8163
Fax Number	:	641-423-3722

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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Directions to “VISION WORLD, INC. ” Practice Location

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