Provider Demographics
NPI:1548345457
Name:VISION WORLD INC
Entity type:Organization
Organization Name:VISION WORLD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:1785 RADIO DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-501-0920
Practice Address - Fax:651-501-0921
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
MN430638400Medicaid
MN1296270003Medicare NSC