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	:	1619120961
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	:	210-524-6587

Provider Business Practice Location Address
First Line	:	9617 N METRO PKWY W
Second Line	:	#1160
City	:	PHOENIX
State	:	AZ
Zip	:	85051-1400
Country	:	US
Telephone Number	:	602-861-1670
Fax Number	:	602-861-1698

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	210-524-6771

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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