1609048222 NPI number — VISIONWORKS INC.

Table of content: BRITTANY QUINN DICKEY LLMSW (NPI 1124779541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609048222 NPI number — VISIONWORKS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISIONWORKS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609048222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 848448
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-8448
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-524-6663
Provider Business Mailing Address Fax Number:
210-524-6587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9644 S. WESTERN AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVERGREEN PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-239-4881
Provider Business Practice Location Address Fax Number:
773-239-4993
Provider Enumeration Date:
03/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCDONALD
Authorized Official First Name:
DOLSIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MVC NETWORK MANAGEMENT MANAGER
Authorized Official Telephone Number:
726-444-4078

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)