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	:	1598405433
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	:	78205-2299
Country	:	US
Telephone Number	:	800-340-0129
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	510 N STREET ROAD 7
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-3523
Country	:	US
Telephone Number	:	561-631-9619
Fax Number	:	561-631-9619

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

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/30/2022

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Directions to “VISIONWORKS, INC. ” Practice Location

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