Provider Demographics
NPI:1578660858
Name:VISION WORLD, INC.
Entity Type:Organization
Organization Name:VISION WORLD, INC.
Other - Org Name:VISION WORLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWCOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6663
Mailing Address - Street 1:11103 WEST AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1370
Mailing Address - Country:US
Mailing Address - Phone:210-524-6663
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:2915 26TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1555
Practice Address - Country:US
Practice Address - Phone:612-724-4444
Practice Address - Fax:612-722-8323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC02911Medicare PIN
MNC02899Medicare PIN
MNC02902Medicare PIN
MNC02913Medicare PIN
MNC02903Medicare UPIN
MNC02905Medicare PIN
MNC02914Medicare PIN
MNC02910Medicare PIN
MNC02904Medicare PIN
MNC02907Medicare PIN
MNC02912Medicare PIN
MNC02909Medicare PIN
MNC02924Medicare PIN
MNC02900Medicare PIN
MNC02906Medicare PIN
MNC02908Medicare PIN