Provider Demographics
NPI:1912457706
Name:VISIONWORKS, INC.
Entity type:Organization
Organization Name:VISIONWORKS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP RETAILO MANAGED VISION CARE
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6515
Mailing Address - Street 1:175 E. HOUSTON STREET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2255
Mailing Address - Country:US
Mailing Address - Phone:210-524-6982
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:300 MONTICELLO AVE
Practice Address - Street 2:SPACE 263
Practice Address - City:NORKFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2426
Practice Address - Country:US
Practice Address - Phone:757-622-0105
Practice Address - Fax:757-622-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier