| Organization Name: | NATIONAL VISION, INC. |
| NPI Number: | 1023402138 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEAHANN VAUGHN (MANAGED CARE SALES COORDINATOR) |
| Mailing Address: | 19075 I 45 S Ste 121-b Shenandoah |
| State: | TX US |
| Postal Code: | 773858704 |
| Phone Number: | 9362711717 |
| Fax Number: | 9362711821 |
| NPI Enumeration Date: | 03/26/2015 |
| NPI Last Update Date: | 03/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |