Provider Demographics
NPI:1649777228
Name:VISION WORKS OPTOMETRY, INC.
Entity Type:Organization
Organization Name:VISION WORKS OPTOMETRY, INC.
Other - Org Name:VISION FIRST OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAY ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-525-8436
Mailing Address - Street 1:2401 E ORANGEBURG AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3396
Mailing Address - Country:US
Mailing Address - Phone:209-525-8436
Mailing Address - Fax:209-525-8438
Practice Address - Street 1:2401 E ORANGEBURG AVE STE 280
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3396
Practice Address - Country:US
Practice Address - Phone:209-525-8436
Practice Address - Fax:209-525-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13644152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty