Basic Information
| Provider Information | |||||||||
| NPI: | 1972540441 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL VISION, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 951336 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753951336 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6050 GORGAS RD | ||||||||
| Address2: | BUILDING 2303 | ||||||||
| City: | FORT BELVOIR | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220606206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037817047 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PURCELL | ||||||||
| AuthorizedOfficialFirstName: | ANNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER NETWORK ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7708224245 | ||||||||
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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.