Wal-Mart Stores Texas LLC

NPI #1114944345 in Dallas, Texas

Provider Information

NPI Number
1114944345
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 19, 2025

Practice Location

Address
15220 MONTFORT RD
City
Dallas
State
Texas
ZIP Code
75248-6401
Phone
(972) 233-8764

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 853-0515

Specialties & Taxonomy Codes

Specialty
Pharmacy
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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