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	:	1689997710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 842375
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-2375
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	15902 CRAIN HWY SOUTH EAST
Second Line	:	STE. F
City	:	BRANDYWINE
State	:	MD
Zip	:	20613-8018
Country	:	US
Telephone Number	:	301-782-4907
Fax Number	:	301-782-1968

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

Provider Enumeration Date	:	03/03/2010
Last Update Date	:	10/22/2013

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Directions to “VISIONWORKS, INC. ” Practice Location

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