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	:	1609029958
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	:	210-524-6803
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	7000 E MAYO BLVD
Second Line	:	BUILDING 4, SUITE 1034
City	:	PHOENIX
State	:	AZ
Zip	:	85054-6151
Country	:	US
Telephone Number	:	480-513-3106
Fax Number	:	480-515-6246

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

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	05/23/2014

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Directions to “VISIONWORKS INC ” Practice Location

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