Provider Demographics
NPI:1619052602
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:OFFICER
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:210-524-6700
Mailing Address - Street 1:11103 WEST AVENUE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:210-524-6663
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:4400 SERGEANT ROAD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106
Practice Address - Country:US
Practice Address - Phone:712-276-4686
Practice Address - Fax:712-276-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN002011700Medicaid
IA0460741Medicaid
MN002011700Medicaid