1861430589 NPI number — NATIONAL VISION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861430589 NPI number — NATIONAL VISION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL VISION, 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:
1861430589
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 951336
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:
75395-1336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
260 COMMISSARY RD
Provider Second Line Business Practice Location Address:
BLDG 7339
Provider Business Practice Location Address City Name:
DYESS AFB
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79607-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-793-1750
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANTOINE
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
PROVIDER NETWORK ADMINISTRATOR
Authorized Official Telephone Number:
678-892-3771

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)