Wal-Mart Stores Texas LLC

NPI #1184641359 in Jasper, Texas

Provider Information

NPI Number
1184641359
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
May 29, 2025

Practice Location

Address
800 W GIBSON ST
City
Jasper
State
Texas
ZIP Code
75951-4914
Phone
(409) 384-7108

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

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

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