Basic Information
| Provider Information | |||||||||
| NPI: | 1760938369 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VISIONWORKS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 848448 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752848448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105246771 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3977 S ARIZONA AVE | ||||||||
| Address2: | STE 5 | ||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852482707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808020199 | ||||||||
| FaxNumber: | 4808020581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 01/10/2017 | ||||||||
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| AuthorizedOfficialLastName: | REYNOLDS | ||||||||
| AuthorizedOfficialFirstName: | DOROTHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP-RETAIL MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 2105246515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.