Basic Information
Provider Information
NPI: 1053494526
EntityType: 2
ReplacementNPI:  
OrganizationName: VISIONWORKS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: VISIONWORKS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 848448
Address2:  
City: DALLAS
State: TX
PostalCode: 752848448
CountryCode: US
TelephoneNumber: 2105246803
FaxNumber: 2105246587
Practice Location
Address1: 1775 K ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200061502
CountryCode: US
TelephoneNumber: 2024636364
FaxNumber: 2028228605
Other Information
ProviderEnumerationDate: 10/20/2006
LastUpdateDate: 10/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: REYNOLDS
AuthorizedOfficialFirstName: DOROTHY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 2105246515
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332H00000X  Y SuppliersEyewear Supplier (Equipment, not the service) 

No ID Information.


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