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	:	1568889111
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	:	210-524-6771
Fax Number	:

Provider Business Practice Location Address
First Line	:	4890 BIG ISLAND DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-7490
Country	:	US
Telephone Number	:	904-642-5658
Fax Number	:	904-642-7343

Authorized Official
Title or Position	:	DIRECTOR MVC
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	210-524-6515

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	03/04/2015

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Directions to “VISIONWORKS, INC ” Practice Location

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